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[1]王華,王國平,應霽翀,等.MRI檢查在膝關(guān)節(jié)滑膜血管瘤診斷中的價值[J].中醫(yī)正骨,2017,29(06):44-48.
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MRI檢查在膝關(guān)節(jié)滑膜血管瘤診斷中的價值()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第29卷
期數(shù):
2017年06期
頁碼:
44-48
欄目:
影像診斷
出版日期:
2017-06-20

文章信息/Info

作者:
王華王國平應霽翀尹彬彬
浙江省寧波市第六醫(yī)院,浙江 寧波 315040
關(guān)鍵詞:
膝關(guān)節(jié) 血管瘤 滑膜 磁共振成像
摘要:
目的:探討MRI檢查在膝關(guān)節(jié)滑膜血管瘤診斷中的價值。方法:采用Siemens Magnetom Avanto syngo 1.5 T超導型MRI掃描儀對11例膝關(guān)節(jié)滑膜血管瘤患者的患膝進行掃描,觀察滑膜血管瘤的信號特點、形態(tài)、范圍及其與周圍結(jié)構(gòu)的解剖關(guān)系,同時對MRI各序列對病變異常信號的顯示能力作出評價。結(jié)果:局限型5例,界限清楚,呈結(jié)節(jié)狀或淺分葉狀; 彌漫型6例,無明顯邊界,輪廓不規(guī)則,“鉆縫”樣突破關(guān)節(jié)囊生長、不同程度侵犯周圍結(jié)構(gòu),其中1例侵蝕破壞股骨內(nèi)髁,1例累及髕骨外后下緣,1例廣泛破壞膝關(guān)節(jié)面呈骨關(guān)節(jié)炎改變、累及半月板及周圍軟組織、周圍軟組織無明顯推移改變。與病變周圍正常肌肉信號相比,4例病變MRI信號較均勻,T1加權(quán)像呈等或略低信號,T2加權(quán)像高信號呈“葡萄串”狀排列,內(nèi)見纖細低信號分隔; 7例病變MRI信號不均勻,T1加權(quán)像以等或低信號為主,夾雜多少不等的細花邊狀、斑片狀、蚯蚓狀分布的高信號,T2加權(quán)像不均勻高信號內(nèi)見小圓形等低信號。2例T1加權(quán)像、T2加權(quán)像病變內(nèi)部見短條狀、斑點狀更低信號,為靜脈石。1例病變T2加權(quán)像見小圓形等低信號,為血栓。2例T1加權(quán)像病變內(nèi)夾雜不規(guī)則低信號,T2加權(quán)像為更低信號,脂肪抑制T2加權(quán)像上顯示更為清晰,為慢性出血、含鐵血黃素沉積。2例增強掃描脂肪抑制質(zhì)子密度加權(quán)像顯示病變迂曲血管延伸至皮下。5例MRI增強掃描表現(xiàn)為不均勻斑片狀、結(jié)節(jié)狀、脈管狀明顯強化,病變界限較平掃顯示更加清楚,內(nèi)部低信號分隔及不規(guī)則低信號區(qū)未見明顯強化。5例見少量關(guān)節(jié)積液。所有患者均未見液-液平面。結(jié)論:MRI檢查特別是增強掃描可以準確定位,清楚顯示血管瘤的特征性信號、形態(tài)、范圍以及與毗鄰結(jié)構(gòu)的關(guān)系,對滑膜血管瘤的診斷和治療方案的選擇具有重要價值,可作為膝關(guān)節(jié)滑膜血管瘤首選的無創(chuàng)性診斷方法。

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備注/Memo

備注/Memo:
浙江省寧波市第六醫(yī)院,浙江 寧波 315040
更新日期/Last Update: 2017-06-20