膝关节区囊性病变的MR诊断与鉴别诊断

MR diagnosis and differential diagnosis of cystic lesions in knee joint area

目的：探讨膝关节区常见囊性病变的MR诊断与鉴别诊断。方法：2005年9月~2010年9月我院共行膝关节MR检查约1 500例,将其中膝关节内及关节周围囊性病变102例进行分析。结果：滑囊囊肿54例、半月板囊肿22例和腱鞘囊肿23例是膝关节区最常见的囊性疾病,其他3例,102例囊性病变中91例表现为长T1长T2信号,8例可见稍短T1信号,3例可见合并其他信号。膝关节周围有很多滑囊,滑囊囊肿位于特定的解剖部位,腘窝囊肿位于腘窝内,一般有狭颈与关节腔相通,形状多不规则;半月板囊肿多位于半月板旁,常数个聚集成排,少数可位于半月板内。腱鞘囊肿位于腱鞘走形方向,多为椭圆形,可多发或分房。结论：囊性病变大多表现为长T1长T2信号,熟练掌握膝关节的解剖学知识、不同囊性病变的病理学知识,对于诊断和鉴别诊断至关重要。

Objective：To explore the MR diagnosis and differential diagnosis of common cystic lesions in knee joint.Methods：1500 cases received the magnetic resonance（MR） examination of knee joints in our hospital from September 2005 to September 2010.102 cases of cystic lesion in knee joint area and periarticular area were collected for analysis.Results：Synovial cyst（54 cases）,meniscus cyst（22 cases） and thecal cyst（23 cases） were the most common cystic diseases in knee joint area,there were 3 cases of other diseases.Among them,91 cases revealed long T1 and long T2 in signal intensity,8 cases revealed slight short T1 in signal intensity,3 cases were combined with other signal intensity.There were many synovial bursas around knee joint area,synovial cyst lied in special area,popliteal cyst lied in popliteal fossa,connecting with joint cavity through a narrow channel and showing irregular shape;most of meniscus cysts were located near themselves,always gathered in a row,few in the meniscus;thecal cyst kept up with tendon sheath in direction,showing oval shape,sometimes multiple or housing distribution.Conclusion：Most cyst lesions reveal long T1 and long T2 in signal intensity.Grasping the knowledge of knee joint＇s anatomy and pathology knowledge of different cystic lesions is most important for diagnosis and differential diagnosis.