色素沉着绒毛结节性滑膜炎声像图特征及其病理学基础

Sonographic Characteristic of Pigmented Villonodular Synovitis and Its Pathology

目的分析色素沉着绒毛结节性滑膜炎(PVNS)声像图表现并进行超声分型,旨在提高对其诊断的准确率,尤其是对局限性结节性滑膜炎的诊断。方法对22例PVNS声像图特征与病理对照分析。结果弥漫性18例,超声诊断正确率94.4%(17/18)。局限性4例,超声诊断正确率75%(3/4)。关节腔内滑膜局限性或弥漫性增厚,关节腔增宽并有积液,有单个或多个低回声或复合回声肿物突入关节腔内,邻近骨皮质受损或骨内囊性变,彩色多普勒血流显像(CDFI)显示肿物周边及内部有血流信号。结论PVNS声像图有一定特点,位于腱鞘或滑囊的局限性结节性滑膜炎,声像图特征不明显,诊断较困难。

Objective To improve the accuracy rate of diagnosis for the pigmented villonodular synovitis（PVNS）, especially for the local nodular synovitis by ultrasound image. Methods The characteristics of the ultrasound images of 22 patients were compared with those of the pathology. Results rllae accuracy was 94.4% （17/18） in the patients with extensive PVNS and 75% （3/4） in the patients with local PVNS. There were five characteristics of PVNS in the ultrasound： local or extensive synovium proliferation, the joint effusion and widen capsular cavity, the nodular masses with hypoechogenicity, medium echo and hyperechogenicity, the extensive blood signal could be detected in the proliferation synovium, and bone destruction or bone cyst was found around the nodulus. Conclusion There are some characteristics in the sonogram of pigmented viUonodular synovitis It＇ s difficult to diagnose the local PVNS in the tendon sheath and bursa because of the absence of these characteristics in the sonogram