创伤性髌前滑囊炎的MRI诊断

目的探讨创伤性髌前滑囊炎的MRI特征.方法回顾性分析经手术病理确诊为髌前滑囊炎,术前均进行过膝关节MRI检查的12例患者.MRI图像分析包括:病灶的大小、部位、形态、平扫的信号特征.结果12例患者病灶最长径2~10cm(平均5.9cm);11例位于髌前,1例位于髌韧带前,与膝关节腔均不相通.病灶形态:3例表现为单房囊状,4例表现为分房状,5例表现扁平状;MRI信号特点:T1WI?8例呈等、低信号,4例内夹杂斑片状高信号,脂肪抑制T2WI或STIR均呈高信号为主.其中3例边缘可见脂肪滴信号;4例内伴出血样信号;1例囊底内可见液液平;3例滑囊壁增厚;病变周围均可见不同程度渗出表现.结论创伤性髌前滑囊炎多位于髌前皮下囊,MRI信号可多样,结合外伤病史,MRI有助于诊断和鉴别诊断.

Objective To investigate the MRI features of traumatic prepatellar bursitis.Methods 12 patients with pathologically proven prepatellar bursitis were retrospectively reviewed.MR examinations of the knee were performed on all these patients before operation.The MR image analysis of the lesion including the size,location,shape,and signal features in plain scan.Results The maximum diameter of 12 lesions in all patients was 2~10cm(average 5.9cm).11 lesions were located in front of the patella,and 1 lesion was located in front of the patella ligament.AU of these were not in communication with the knee joint cavity.Lesion shape:3 lesions showed unilocular cystic,4 lesions showed bilocular and 5 lesions showed flat.Features of MRI signal:8 lesions showed isointense and hypointense on T1W1,4 lesions were mixed with patchy hyperintense,and FS T2WI or STIR showed hyperintense mainly.Among them,signal of fat drop in 3 lesions were seen at the edge.Blood signal were observed in 4 lesions.In 1 lesion liquid level was visible in the bottom of the sac.In 3 lesions the wall of the synovial bursa were thickened.All around the lesions,different degrees of exudation were observed.Conclusion Traumatic prepatellar bursitis mostly locates in the subcutaneous prepatellar bursa.MR signs can be diverse.Combined with the history of trauma,MRI can help diagnose and differential diagnosis.