树枝状脂肪瘤的影像学诊断

The Imaging Diagnosis of Lipoma Arborescens(LA)

目的探讨树枝状脂肪瘤的影像学特点。方法回顾分析12例经手术及病理证实为树枝状脂肪瘤的影像学特点,其中9例x行X线检查,8例行CT扫描,12例行MR检查。结果11例单发,病灶均位于髌上囊区,1例多发,病灶位于髌上囊区和左髋关节囊。9例MR见髌上囊滑膜明显增厚,呈树枝状改变,3例髌上囊滑膜轻度增厚,呈绒毛状改变;增厚的滑膜T1WI上表现为高信号、T2WI上表现为稍高信号,脂肪抑制序列上表现为低信号,梯度回波序列上表现为高、低混杂信号;增强扫描增厚的滑膜明显强化;12例髌上囊均有积液,1例左髋关节病变合并髋臼脂肪瘤及少量积液,7例合并骨性关节炎,4例软骨均轻度损伤。结论树枝状脂肪瘤的MR表现具有特异性,可用于术前诊断。

Objective To investigate the imaging characteristic of lipoma arborescens(LA).Methods The imaging features of 12 cases with LA proved by surgical pathology were analyzed retrospectively.Nine cases were examined with X-ray,eight cases were examined with CT and twelve cases were examined with MRI.Results Eleven cases were isolated and located at the suprapatellar bursas.One case was multiple,lesions located at the suprapatellar bursas and the hip capsule.MR images of 9 cases showed that the synovium of suprapatellar bursa was markedly thicker and dendritic in 9 cases,slightly thicker and villous in 3 cases,slightly higher signal on T1WI,slightly higher signal on T2WI,low signal on fat suppression sequence,and high and low mixed signal on gradient echo sequence.The thickened synovium was obviously enhanced.Hydrocele was found in 12 cases of suprapatellar sac,acetabular lipoma and a small amount of hydrocele in 1 case of left hip joint lesion,osteoarthritis in 7 cases,and mild cartilage injury in 4 cases.Conclusion The MR findings of LA are specific and can be used for preoperative qualitative diagnosis.