滑膜骨软骨瘤病的影像诊断

Imaging Diagnosis of Synovial Osteochondroma

目的:分析滑膜骨软骨瘤病的影像表现及特征,从而提高临床对滑膜骨软骨瘤病的诊治效率。方法:选取60例2016年1月至2017年10月期间收治的滑膜骨软骨瘤病患者,所有患者均给予X线平片检查,28例给予CT平扫检查,32例给予MRI检查,观察不同方法的影像表现和诊断效果。结果:X线主要表现为患侧关节内、关节旁及周围可见数目不等、形态不一、大小不等的软骨瘤钙化或骨化影,钙化软骨瘤结节体密度不匀,较大钙化或骨化结节可表现为中心低密度,周缘高密度。CT平扫均能清晰显示患者软骨瘤结节,可显示患者的边缘骨质增生、关节积液以及关节滑膜增厚等情况。MRI检查均可见早期关节病变,钙化软骨结节在T1WI和T2WI图像上均表现为低信号,伴有关节软组织肿胀患者T1WI图像表现为低信号,T2WI图像表现为等高信号;伴有关节积液患者T1WI和T2WI分别表现为低信号和高信号。所有患者均经手术病理证实为滑膜骨软骨瘤病,且软骨瘤结节大小、数目、位置等情况与X线平片、CT以及MRI检查结果基本符合。结论:X线、CT及MRI等影像学检查在滑膜骨软骨瘤病诊断中具有较高应用价值,能够为临床手术方案制定提供重要依据。

Objective： To analyze the imaging presentations and features of synovial osteochon-dromatosis and to improve the efficiency of diagnosis and treatment. Methods： 60 patients diagnosed with synovial osteochondromatosis were selected from January 2016 to October 2017 and were treated by X-ray examination. 28 cases were done by CT, while 32 cases were treated by MRI. Results： The X-ray results showed that the calcification or ossification of chondroma with different numbers, shapes and sizes distributed in and around the affected joint, and the density of calcified chondroma tubercle was uneven. CT results scan can clearly show many patients＇ syndromes such as chondroma nodules,edge of bone hyperplasia, joint effusion and synovial thickening. MRI results represented early joint lesions and low signals of Calcified cartilage nodules on T_1WI and T_2WI images, and high signals of joint effusion on T_1WI images but low one on T_2WI image. All the patients were proved to be synovial osteochondromatosis by operation and pathology. The information about the sizes, numbers and locations of chondroma nodules were consistent with results of the X-ray, CT and MRI. Conclusion： X-ray, CT,MRI and other imaging examinations are high value in the diagnosis of synovial osteochondromatosis,and can provide important basis to planclinical operation.