膝关节色素沉着绒毛结节性滑膜炎MRI表现与病理对照分析

Correlation of MRI and Pathology Manifestations of Pigmented Villonodular Synovitis of Knee Joint

目的:探讨膝关节色素沉着绒毛结节性滑膜炎(PVNS)的MRI表现与病理变化的关系。方法:对20例膝关节PVNS的MRI影像进行回顾性分析,并与手术病理结果对照。结果:20例膝关节PVNS均为弥漫型,病理特征为滑膜增厚呈结节状或绒毛状,有丰富的血管和大量含铁血黄素沉着。MRI表现均有滑膜增厚、关节内软组织结节,T1WI呈等或低信号,T2WI呈低信号;均有不同程度关节积液;关节内脂肪垫受侵15例;半月板及交叉韧带受累10例;软骨或骨受侵16例。结论:MRI对膝关节PVNS有特征性表现,并敏感显示关节内外组织结构的侵犯程度及范围,MRI是诊断PVNS的理想检查方法。

Objective：To study the correlation of MRI features and pathologic changes of pigmented villonodular synovitis（PVNS） of knee joint.Methods：MRI of knee joint in 20 cases with PVNS were studied retrospectively,and correlated with surgical and pathological findings.Results：All of the twenty cases with PVNS were diffuse type.The basic pathological changes were nodular or villous proliferation of synovial tissue;with massive hemosiderin deposition and abundant blood vessels.The MRI manifestations were thickened synovial tissue,intra-articular soft tissue nodules,which were iso-/hypo-intense on T1WI,and hypointense on T2WI.Various degree of intra-articular effusion was seen in all case;invasion of articular fat pad in 15 cases;destruction of meniscus and cruciate ligament in 10 cases;cartilage and skeletal erosion in 16 cases.Conclusion：Characteristic manifestations of PVNS of knee joint could be showed on MRI,the extent as well as the degree of intra-and extra-articular invasion could also be revealed.MRI is an ideal modality for the diagnosis of PVNS of the knee joint.