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MRI-pathologic correlation of pigmented villonodular synovitis
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 6
- DOI:
- 10.3760/j.issn:1005-1201.2003.06.004
- Key Word:
- 滑膜炎,色素绒毛结节性;磁共振成像;病理学
Abstract： 目的研究色素沉着绒毛结节性滑膜炎(PVNS)MRI表现的病理基础及其在扩散加权像(DWI)上异常信号改变的机制.方法分析7例PVNS的MRI表现,计算DWI上异常信号灶的表观扩散系数(ADC),并与手术病理结果进行对照分析.结果 7例PVNS中弥漫型5例(膝关节4例,肩关节1例).MRI主要表现为关节滑膜广泛增生,呈长T1、长T2信号,其内见含铁血黄素沉着,呈长T1、短T2信号;4例见膝关节腔积液,呈长T1、长T2信号;半月板破坏3例,前、后交叉韧带破坏2例,呈结节状长T1、长T2 信号;4例见关节内软骨和邻近骨质明显破坏(膝关节3例,肩关节1例),1例股骨骨质呈小囊状破坏.局限型2例(膝关节、髋关节各1例),主要表现为滑膜结节状增生,其内亦可见含铁血黄素沉着,呈长T1、短T2信号.1例见关节腔内少许积液,邻近股骨骨质小囊状破坏.DWI上关节积液、滑膜增生及邻近骨质破坏表现为异常高信号,其平均ADC值分别为2.750×10-3 mm2/s,0.522×10-3 mm2/s,0.559×10-3 mm2/s.结论滑膜绒毛结节状增生及其内点状或结节状含铁血黄素沉着是PVNS的典型表现,在MRI上具有一定的特征性;DWI有助于区分PVNS病变的不同组织成分;病变组织的ADC值下降,其对鉴别诊断的意义有待进一步研究.
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