关节色素沉着绒毛结节性滑膜炎MRI诊断价值

MRI Diagnosis of Pigmented Villonodular Synovitis

目的 探讨MRI在关节色素沉着绒毛结节性滑膜炎 (PVNS)诊断中的价值。资料与方法 回顾性分析1 2例经病理证实的关节PVNS的MRI、X线平片和关节镜等影像资料 ,比较和评价PVNS的MRI信号特点 ,关节内结构侵犯、关节外侵犯和骨质侵蚀等征象。结果 1 2例关节PVNS,8例MRI具有典型的含铁血黄素沉着 ,T1 WI和T2 WI呈等低信号。MRI可以准确显示X线平片难以显示的骨质侵蚀、关节内软骨和韧带侵蚀以及关节外侵犯的范围 ,对关节内关节软骨、半月板和交叉韧带侵蚀的显示和关节镜相当。结论 MRI在PVNS诊断中具有特征性的MRI信号及很高的诊断价值 ,可以取代诊断性的关节镜检查 ,MRI可准确评价PVNS在关节内外的侵犯范围 ,对指导手术。

Objective To evaluate MRI in the diagnosis of pigmented villonodular synovitis (PVNS).Materials and Methods MRI, radiographic and arthroscopic findings in 12 patients with pathologically proved PVNS were retrospectively analyzed. MRI signal features, the involvement of intra and extra articular structures and bony erosion were evaluated.Results Of 12 cases, iso low signal on T 1WI and T 2WI, typical for hemosiderin deposition, was seen in 8. Bony erosion, involvement of intra articular cartilage and ligament, and the invasion of extra articular structures, which were hard to be displayed on plain film, were well demonstrated on MRI. Besides, MRI was comparable to arthroscopy in displaying the involvement of intra articular cartilage, meniscus and cruciate ligament.Conclusion MRI is of great value in diagnosing PVNS and can substitute for arthroscopy. MRI can precisely evaluate intra and extra articular invasion, which is very important in guiding surgery and avoiding recurrence.