[1]王华,王国平,应霁翀,等.MRI检查在膝关节滑膜血管瘤诊断中的价值[J].中医正骨,2017,29(06):44-48.
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MRI检查在膝关节滑膜血管瘤诊断中的价值()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期数:
2017年06期
页码:
44-48
栏目:
影像诊断
出版日期:
2017-06-20

文章信息/Info

作者:
王华王国平应霁翀尹彬彬
浙江省宁波市第六医院,浙江 宁波 315040
关键词:
膝关节 血管瘤 滑膜 磁共振成像
摘要:
目的:探讨MRI检查在膝关节滑膜血管瘤诊断中的价值。方法:采用Siemens Magnetom Avanto syngo 1.5 T超导型MRI扫描仪对11例膝关节滑膜血管瘤患者的患膝进行扫描,观察滑膜血管瘤的信号特点、形态、范围及其与周围结构的解剖关系,同时对MRI各序列对病变异常信号的显示能力作出评价。结果:局限型5例,界限清楚,呈结节状或浅分叶状; 弥漫型6例,无明显边界,轮廓不规则,“钻缝”样突破关节囊生长、不同程度侵犯周围结构,其中1例侵蚀破坏股骨内髁,1例累及髌骨外后下缘,1例广泛破坏膝关节面呈骨关节炎改变、累及半月板及周围软组织、周围软组织无明显推移改变。与病变周围正常肌肉信号相比,4例病变MRI信号较均匀,T1加权像呈等或略低信号,T2加权像高信号呈“葡萄串”状排列,内见纤细低信号分隔; 7例病变MRI信号不均匀,T1加权像以等或低信号为主,夹杂多少不等的细花边状、斑片状、蚯蚓状分布的高信号,T2加权像不均匀高信号内见小圆形等低信号。2例T1加权像、T2加权像病变内部见短条状、斑点状更低信号,为静脉石。1例病变T2加权像见小圆形等低信号,为血栓。2例T1加权像病变内夹杂不规则低信号,T2加权像为更低信号,脂肪抑制T2加权像上显示更为清晰,为慢性出血、含铁血黄素沉积。2例增强扫描脂肪抑制质子密度加权像显示病变迂曲血管延伸至皮下。5例MRI增强扫描表现为不均匀斑片状、结节状、脉管状明显强化,病变界限较平扫显示更加清楚,内部低信号分隔及不规则低信号区未见明显强化。5例见少量关节积液。所有患者均未见液-液平面。结论:MRI检查特别是增强扫描可以准确定位,清楚显示血管瘤的特征性信号、形态、范围以及与毗邻结构的关系,对滑膜血管瘤的诊断和治疗方案的选择具有重要价值,可作为膝关节滑膜血管瘤首选的无创性诊断方法。

参考文献/References:

[1] VILANOVA JC,BARCELÓ J,SMIRNIOTOPOULOS JG,et al.Hemangioma from Head to Toe:MR imaging with pathologic correlation[J].Radiographics A Review Publication of the Radiological Society of North America Inc,2004,24(2):367-385.
[2] LOPEZOLIVA CL,WANG EH,CAÑAL JP.Synovial haemangioma of the knee:an under recognised condition.[J].International Orthopaedics,2015,39(10):2037-2040.
[3] NARVÁEZ JA,NARVÁEZ J,AGUILERA C,et al.MR imanging of synovial tumors and tumor-like leisons[J].European Radiology,2001,11(12):2549-2560.
[4] DERZSI Z,GURZU S,JUNG I,et al.Arteriovenous synovial hemangioma of the popliteal fossa diagnosed in an adolescent with history of unilateral congenital clubfoot:case report and a single-institution retrospective review[J].Rom J Morphol Embryol,2015,56(2):549-552.
[5] 孙英彩,崔建岭,丁洋,等.滑膜血管瘤临床和影像表现[J].中华放射学杂志,2012,46(5):466-468.
[6] Greenspan A,Azouz EM,DÉCARIE JC.Synovial hemangioma:imaging features in eight histologically proven cases,review of the literature,and differential diagnosis[J].Skeletal Radiol,1995,24(8):583-590.
[7] FILIPPO MD,ROVANI C,SUDBERRY JJ,et al.Magnetic resonance imaging comparison of intra-articular cavernous synovial hemangioma and cystic synovial hyperplasia of the knee[J].Acta radiol,2006,47(6):581-584.
[8] DEVANEY K,VINH TN,SWEET DE.Synovial hemangioma:a report of 20 cases with differential diagnostic considerations[J].Hum Pathol,1993,24(7):737-745.
[9] KAYA A,IMERCI A,TUZLU M,et al.Extra-articular synovial hemangiaoma of the knee; an unusual location in the popliteal region[J].Anatolian Journal of Clinical Investigation,2014,8(2):82-85.
[10] DE GORI M,GALASSO O,GASPARINI G.Synovial hemangioma and osteoarthritis of the knee:a case report[J].Acta Orthop Traumatol Turc,2014,48(5):607-610.
[11] MAEYAMA A,SAEKI K,HAMASAKI M,et al.Deformation of the patellofemoral joint caused by synovial hemangioma:a case report[J].Journal of Pediatric Orthopaedics-Part B,2014,23(4):346-349.
[12] WATANABE S,TAKAHASHI T,FUJIBUCHI T,et al.Synovial hemangioma of the knee joint in a 3-year-old girl[J].Journal of Pediatric Orthopaedics-Part B,2010,19(6):515-520.
[13] WEN DW,TAN TJ,RASHEED S.Synovial haemangioma of the knee joint: an unusual cause of knee pain in a 14-month old girl[J].Skeletal Radiol,2016,45(6):827-831.
[14] ARSLAN H,SLAMOLU N,AKDEMIR Z,et al.Synovial hemangioma in the knee:MRI findings[J].J Clin Imaging Sci,2015,5(1):23.
[15] MAHATA M,GAYEN R,DASGUPTA S,et al.Synovial hemangioma of the ankle joint:a rare and unusual encounter[J].International Journal of Biomedical Research,2015,6(9):726.
[16] BELTRAME V,ROMANUCCI G,ZULIAN F,et al.Synovial hemangioma of infrapatellar(hoffa)fat pad:magnetic resonance imaging and ultrasound features[J].Journal of Pediatrics,2016,172:222-223.
[17] BEGLY JP,RAPP TB,SHAH MR.Synovial hemangioma presenting as a painful locked knee a case report[J].Bulletin of the Hospital for Joint Disease,2016,74(4):309.

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备注/Memo

备注/Memo:
浙江省宁波市第六医院,浙江 宁波 315040
更新日期/Last Update: 2017-06-20