脊柱色素沉着绒毛结节性滑膜炎的影像学表现

发布时间：2018-04-06 07:16

本文选题：脊柱疾病　切入点：滑膜炎　出处：《中国医学影像学杂志》2015年02期

【摘要】：目的探讨脊柱色素沉着绒毛结节性滑膜炎的CT和MRI表现,提高术前诊断的准确性。资料与方法回顾性分析7例经手术和病理证实的脊柱色素沉着绒毛结节性滑膜炎的CT和MRI征象,其中7例行CT扫描,5例行MRI扫描,分析其病变部位、肿块大小、形态、密度(信号)、骨质破坏情况及增强特点。结果 7例患者中,除1例病灶较小外,其余6例均出现分叶状软组织肿块,均以椎小关节区域为中心;1例病灶较小、无明显骨质破坏,6例均出现以椎小关节为中心的骨质破坏,均呈溶骨性、膨胀性骨质破坏。7例均行CT扫描,3例软组织肿块密度与周围肌肉类似,4例密度比周围肌肉稍低。5例行MRI扫描,1例病灶较小,边缘可见低信号;1例信号均匀,未见明显低信号结节;3例软组织肿块内部可见特异性的多发散在低信号结节。结论脊柱病变的骨质破坏以椎小关节为中心且软组织肿块呈特征性MRI信号时,应考虑脊柱色素沉着绒毛结节性滑膜炎的可能。
[Abstract]:Objective to investigate CT and MRI findings of pigmented villonodular synovitis of spine and to improve the accuracy of preoperative diagnosis.Materials and methods CT and MRI findings of 7 cases of spinal pigmented villonodular synovitis proved by surgery and pathology were retrospectively analyzed. Among them, 7 cases were examined by CT scan and 5 cases by MRI scan.Density (signal, bone destruction and enhancement characteristics).Results in 7 cases, except for one case with small lesion, 6 cases had lobular soft tissue mass, and 1 case had small focus, with the region of facet joint as the center.No obvious bone destruction was found in all 6 cases with vertebral facet joints as the center and all of them were osteolytic.The density of soft tissue mass in 3 cases was slightly lower than that in surrounding muscle. 5 cases had MRI scan. 1 case had small focus and 1 case had homogeneous signal intensity at the edge of soft tissue mass in 7 cases of expansive bony destruction, 3 cases had soft tissue mass density similar to that of surrounding muscle and 4 cases had lower density of soft tissue mass than that of surrounding muscle.There were no obvious hypointensity nodules in 3 cases of soft tissue masses.Conclusion the possibility of pigmented villonodular synovitis of spine should be considered when bony destruction of spinal lesions is centered on facet joints and soft tissue masses show characteristic MRI signals.
【作者单位】：北京大学第三医院放射科;
【基金】：国家自然科学基金项目(81471634)
【分类号】：R686.7;R445.2;R816.8

【参考文献】