间接磁共振关节造影在色素沉着绒毛结节性滑膜炎中的应用

目的探讨间接磁共振关节造影在色素沉着绒毛结节性滑膜炎(pigmented villonodular synovitis,PVNS)中的诊断价值。资料与方法回顾性分析12例经手术及病理证实的PVNS患者的常规MRI、间接磁共振关节造影(indirect MR arthrography,I-MRa)资料。结果12例PVNS患者中关节滑膜呈弥漫性增生肥厚者10例,局限性2例。常规MR表现为T1WI等信号,T2WI高信号2例;T1WI、T2WI均为低信号9例。I-MRa表现为在关节积液的极高信号背景下增生肥厚滑膜呈中等强化的高信号,并对周围正常组织有不同程度的侵蚀。结论I-MRa与常规扫描序列相结合,不仅能更清晰地显示出病变累及的范围和程度,而且还可以显示滑膜对关节骨质的侵蚀、反映病变的血供等病理改变,从而可进一步提高PVNS定性及分期的准确性。

The Application of Indirect MR Arthrography in Diagnosis of PVNS

Objective To investigate the application of indirect MR arthrography(I-MRa) in diagnosis of pigmented villonodular synovitis(PVNS).Materials and Methods The routine MRI and indirect MR arthrography findings of 12 cases with PVNS confirmed by pathology were retrospectively analyzed.Results The synovium thickened diffusedly in 10 cases,and focally in 2 cases.The thickened synovium showed low signal on both T1WI and T2WI in 9 cases,low signal on T1WI and high signal on T2WI in 3 cases.The indirect MR anthrography showed the high signal of the enhanced thickened synovium within the background of hydrarthrosis with extremely high signal,and destruction of bone and soft tissue by the synovial proliferation.Conclusion Combining with routin MRI,indirect MR arthrography can demonstrate more information of PVNS,including the range,degree and angiogenesis of the synovial proliferation,which can further improve the accuracy of qualify and grade PVNS.