滑膜血管瘤的影像诊断分析

Imaging Diagnosis of Synovial Hemangioma

目的探讨滑膜血管瘤的影像学表现及临床诊断价值。资料与方法回顾性分析经病理证实的16例(男9例,女7例)滑膜血管瘤患者资料,其中膝关节14例,肘关节1例,髋关节1例。X线平片检查13例,CT平扫1例,MRI平扫及增强扫描15例,血管造影1例。结果 X线平片可见软组织肿胀、静脉石、软组织肿块表现。CT表现为软组织肿胀及骨质侵蚀。血管造影见毛细血管期及静脉期对比剂滞留。MRI显示肿块T1WI呈等低信号,T2WI呈"葡萄串"样高信号或不均匀等低信号,其内见条索状或网格状低信号分隔。MRI表现各异由病理组织成分不同所决定。结论 X线平片、CT、血管造影对滑膜血管瘤定性诊断价值有限,MRI对滑膜血管瘤的定位及定性诊断具有重要价值,是术前诊断的首选方法,对治疗方案的选择具有指导作用。

Objective To investigate the imaging features and the diagnostic value of synovial hemangioma.Materials and Methods Sixteen cases（9 males,7 females） of synovial hemangioma,included 14 in knee,1 in elbow and 1 in hip joint,had been proved by pathology.Imaging examinations inculding plain radiography（n = 13）,computed tomography（n = 1）,magnetic resonance imaging（n = 15） and angiography（n = 1） were performed.Results Plain films showed joint effusion,phleboliths and soft masses.CT images showed joint effusion and bone erosions.Angiography showed stagnation of constrast medium.MRI signal intensity of masses appeared iso-hypointensity on T2WI,resembling a bunch of grapes hyperintensity or iso-hypointensity on T2WI.The MRI signal variety dependented on the histologic components.Conclusion The diagnostic values of plain films,computed tomography and angiography for synovial hemangioma are limited.MRI can make the correct diagnosis and precisely localized synovial hemangioma,which should be the first choice for preoperative diagnosis and guidance for clinic treatment.