摘要
目的：探讨滑膜软骨瘤病的影像表现，并与病理学结果对照，评价各种影像学检查手段的价值。材料和方法：分析18例经病理证实的滑膜软骨瘤病患者的影像资料，包括X线平片、CT和MR影像表现，并与Milgram病理分期对照。男11例，女7例，年龄30～78岁，平均41.5岁。肘关节1例，肩关节1例，髋关节5例，膝关节8例（9个关节），踝关节2例，颞下颌关节1例。结果：X线平片典型表现为关节间隙及关节周围存在高密度结节影，为“同心层”状；见于Milgram Ⅱ、Ⅲ期的患者。CT表现为关节内数量不等的游离体，滑膜异常增厚、密度增高；MR表现为滑膜增厚、关节内游离体、关节积液和关节退行性改变，关节内游离体表现为软骨结节和骨性结节，结节表面可有强化。Milgram Ⅰ期患者X线平片阴性，CT和MR可以显示X线平片不能显示的滑膜异常，Milgram Ⅱ、Ⅲ期的患者，CT和MR显示关节内游离体和滑膜病变同时存在，对病变细节的显示明显优于X线平片。结论：滑膜软骨瘤病Milgram Ⅱ、Ⅲ期的患者X线平片和CT有特征性的钙化表现，CT和MR可以提供更多关节内游离体和滑膜病变的信息，对于诊断X线平片阴性的Milgram Ⅰ期病例具有重要价值。
Abstract
Objective: To explore imaging features of synovial chondromatosis correlated with pathology, and evaluate the value of different imaging examinations. Methods: The imaging data of 18 cases of pathologically confirmed synovial chondromatosis, who underwent the preoperative plain film, CT and MR plain-scan and enhanced-scan were analysed retrospectively. Amonge these cases, 11 males, 7 females, 30～78 years old, average age was 41.5 years old. One case was elbow joint, one case was shoulder joint, five cases were hip joint, eight cases were knee joint, two cases were ankle joint, one case was temporomandibular joint. Results: On X-ray, typical feature of synovial chondromatosis was free bodies in the joint space and soft tissue, which showed the “concentric lamina” sign, particularly in the cases of Milgram Ⅱ and Ⅲ stage. CT images showed much more free bodies and thickened hyperdense synovium. MR images clearly showed thickened synovium, free bodies, joint effusion and joint degenerative lesions, free bodies displayed two kinds of appearance, cartilaginous body and bony body with ring enhancement after using contrast material. For the Milgram Ⅰ stage cases, CT and MR showed the thickening synovium without positive features on plain film. CT and MR were superior to X-ray in showing the number and position of free body and synovial lesions especially on showing the cartilaginous free bodies. Conclusion: Synovial chondromatosis have characteristic radiological features with different imaging examinations, particularly CT and MR images provide much more information about free body and synovial lesions, are superior in the diagnosis of Milgram Ⅰ stage cases.
关键词
软骨瘤病 /
滑膜 /
放射摄影术 /
体层摄影术 /
X线计算机 /
磁共振成像
Key words
Chondromatosis /
synovial /
Radiography /
Tomography /
X-ray computed /
Magnetic resonance imaging
董 越;伍建林;张丽芝;李 丽.
滑膜软骨瘤病的影像表现与病理对照分析[J]. 中国临床医学影像杂志. 2009, 20(10): 736-739
DONG Yue;WU Jian-lin;ZHANG Li-zhi;LI Li.
The imaging features of synovial chondromatosis and correlation with pathology[J]. Journal of China Clinic Medical Imaging. 2009, 20(10): 736-739
中图分类号：
Ｒ738.2
Ｒ814.41
Ｒ814.42
Ｒ445.2
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