儿童米粒体滑囊炎的影像学分析及术后随访

Pre-and postoperative imaging findings of rice bodies bursitis in children

目的:分析儿童米粒体滑囊炎的术前及术后随访影像学特点,以提高该病的诊断率及了解术后恢复情况。方法:回顾性分析经手术病理证实的7例儿童米粒体滑囊炎的术前及术后随访影像表现。7例术前均行MRI及DR检查,其中3例行CT检查,术后复查均行MRI检查。结果:7例发病部位均为膝关节,其中右膝4例,左膝3例。MRI显示膝关节腔及髌上囊内多发米粒体小结节影,以分布在髌上囊内更多更明显,T_(2)WI压脂信号稍低但略高于肌肉信号,可见滑膜增厚,其中5例见小的树枝状脂肪瘤;CT见关节腔积液,其内无高密度结节影;DR仅表现为软组织肿胀。术后复查MRI显示积液较术前明显减少,滑膜增厚明显减轻。随访时间段内所有病例未见复发。结论:T_(2)WI压脂序列可显示关节腔内多发稍低信号的米粒体、滑膜增厚以及树枝状脂肪瘤,有助于提高米粒体滑囊炎的诊断率,术后MRI复查显示手术取得良好效果。

Objective:To summarize the imaging manifestations of preoperative and postoperative rice bodies bursitis(RBB)in children for improving its diagnostic accuracy and understanding the imaging finding of the postoperative recovery.Methods:A total of seven children with rice bodies bursitis confirmed by surgery and pathology in our hospital were retrospectively reviewed.X-ray and non-enhanced MRI were performed in all seven cases before operations,additional CT scans were performed in 3 cases,and follow-up MRI scans were performed in all 7 children after operations.Results:All seven RBB cases occurred in knee joint(4 cases in the right knee;3 cases in the left knee).MRI showed numerous small rice bodies as Hypo-intense signal on fat-saturated T_(2)WI(FS-T_(2)WI)in the articular cavity and suprapatellar bursa of the knee,more often in the suprapatellar capsule,which being slightly higher signal when compared to muscle signal.Synovial hyperplasia was observed,five cases had small dendritic lipomas.CT scanning showed an increased effusion without high density nodules,X-ray manifested only as swelling of peri-knee soft tissue.Postoperative follow-up MRI showed that the effusion was significantly reduced with an improvement of the synovial hyperplasia.No recurrence was observed in all cases during the follow-up period.Conclusion:FS-T_(2)WI sequence can character numerous hypo-intense signal rice bodies,synovial hyperplasia and dendritic lipoma in the joint cavity,which are helpful to improve the diagnostic accuracy of rice body bursitis.Postoperative follow-up MRI can be used to show a good therapeutic effect.