原发性滑膜骨软骨瘤病的影像学诊断

Imaging Diagnosis of Primary Synovial Osteochondromatosis

目的分析原发性滑膜骨软骨瘤病(primary synovial osteochondromatosis,PSOC)的影像学表现特点,以期提高对本病的诊断水平。方法收集经手术及病理证实的PSOC共46例进行回顾性分析。46例均行X线平片检查,其中行CT平扫28例,MRI平扫12例。结果 X线平片主要见关节内多发大小不一、数目不等的游离体、悬垂体影,多层螺旋CT平扫可更清晰显示关节和滑囊内较小的游离体、增厚的滑膜及关节腔积液。MRI可见未钙化的滑膜软骨瘤结节,并可清晰地显示软骨、滑膜及周围软组织改变。结论 X线平片和CT可以清楚显示钙化或骨化的软骨结节,对于PSOC MilgramⅡ、Ⅲ期有重要诊断价值;而对于其Ⅰ期病例的未钙化或骨化的软骨结节,X线平片和CT难以显示,MRI则往往能够清楚显示,从而可望做出正确诊断。因而影像学在本病的诊断中起着非常重要的作用。

Objective To improve the diagnostic rate of primary synovial osteochondromatosis by analyzing the imaging features.Methods Analyze 46 cases of primary synovial osteochondromatosis which confirmed by surgery and pathology retrospectively.All 46 cases were undergone X-ray examination,of which 28 cases underwent CT examination and 12 cases underwent MRI examination.Results X-ray plain film showed multiple sizes and numbers of free bodies and dangling bodies.Spiral CT plain scan can clearly find the smaller free body,thickening of the synovial fluid and joint effusion in the joint and synovial bursa.Conclusion X-ray plain film and CT can clearly show the calcification or ossification of the cartilage nodules and have important value in the diagnosis of Milgram stageⅡandⅢsynovial osteochondromatosis.MRI is able to show cartilage tumor nodules without calcification or ossification in Milgram I clearly,which is expected to make a correct diagnosis.Therefore imaging plays a very important role in the diagnosis of this disease.