膝关节色素沉着绒毛结节性滑膜炎MRI表现

MRI Features of Pigmented Villonodular Synovitis of Knee Joint

目的探讨膝关节色素沉着绒毛结节性滑膜炎的MRI表现,提高对该疾病的认识。方法对我院经手术病理证实的27例膝关节PVNS的MRI表现进行回顾性分析。结果 27例PVNS中,弥漫型者22例,局限型者5例。所有弥漫型PVNS患者均表现为滑膜呈绒毛状或结节状增厚,T1WI呈低信号,T2WI及PDW呈不均匀稍高信号,增强扫描滑膜明显强化。膝关节周围脂肪垫区、髌上囊及腘窝可见大小不等软组织结节影。增厚滑膜及结节内见条片状或点状异常信号影,T1WI呈低信号,T2WI呈低信号,无明显强化。9例伴有关节软骨及软骨下骨破坏。前后交叉韧带受累1例。所有患者见不同程度关节积液。局限型者表现为关节腔内单发的软组织肿块,伴关节积液。结论膝关节PVNS具有较特征的MRI表现,MRI是诊断PVNS的首选方法。

Objective To investigate the MRI manifestations of pigmented villonodular synovitis of the knee and to improve the understanding of this disease. Methods MRI imaging of 27 patients of PVNS of knee joint confirmed by operation and pathology were retrospectively analyzed. Results Among the 27 PVNS, 22 cases were diffuse type and 5 cases were localized type. All patients with diffuse PVNS presented villous or nodular synovial thickening, low signal on T1 WI, slightly high signal on T2 WI and PDW, and significantly enhanced on enhanced scanning. Soft tissue nodules of different sizes were observed in the fat pad area around the knee joint, suprapatellar capsule and popliteal fossa. Abnormal signal were seen in the thickened synovium and nodules, with lamellar or spotty pattern, low signal in T1 WI and low signal in T2 WI, and no obvious enhancement. 9 cases were associated with the destruction of articular cartilage and subchondral bone, and 1 case of Anterior and posterior cruciate ligament involvement. All patients showed varying degrees of hydrarthrosis. The localized type presents as a single soft tissue mass with hydrarthosis in the articular cavity. Conclusion PVNS of the knee has a characteristic appearance in MRI, which is the most sensitive and specific tool for diagnosing PVNS.