膝关节树枝状脂肪瘤的MRI征象分析及其与骨性关节炎关系的探讨

发布时间：2018-12-15 23:54

【摘要】：目的研究膝关节树枝状脂肪瘤(LA)的典型MRI表现以及伴随病变,并探讨其与骨性关节炎的关系。方法回顾性分析13例LA患者的膝关节(n=15)MRI图像,其中2个膝关节为病理证实,其余13个膝关节有典型MRI表现诊断。所有患者均行MR平扫,其中1例行增强扫描。结果全部病例均累及髌上囊,其中3例同时蔓延至关节周围滑膜,MR表现为滑膜呈"树叶"状、"树枝"状、"绒毛"状增厚,T1WI序列上为高信号、T2WI序列上为稍高信号,脂肪抑制序列上呈低信号,1例增强后滑膜呈明显强化。其中局灶结节型6.7%(1/15),弥漫型53.3%(8/15),混合型40.0%(6/15)。15个受累膝关节均伴关节积液;其中93.3%(14/15)伴骨性关节炎改变;40.0%(6/15)伴半月板损伤;26.7%(4/15)伴滑膜囊肿;20.0%(3/15)伴关节旁滑膜增厚;6.7%(1/15)伴滑膜骨软骨瘤病。结论膝关节LA在MRI上有特征性的形态信号改变,LA是引起骨性关节炎的因素之一。
[Abstract]:Objective to study the typical MRI features and associated lesions of (LA) of knee joint dendritic lipoma and its relationship with osteoarthritis. Methods the MRI images of 13 patients with LA were analyzed retrospectively. Two of them were pathologically confirmed and the other 13 had typical MRI findings. All patients underwent MR plain scan, 1 of which underwent enhanced scan. Results all cases involved the suprapatellar sac, 3 of them spread to the synovial membrane around the joint at the same time. MR showed that the synovium was "leaf", "branch", "villous" thickened, T1WI sequence was hyperintense, and T2WI sequence was slightly hyperintense. Fat suppression sequence showed low signal intensity, and synovial membrane was obviously enhanced after enhancement in 1 case. Among them, focal nodular type was 6.7% (1 / 15), diffuse type was 53.3% (8 / 15), mixed type was 40.0% (6 / 15). 40.0% (6 / 15) with meniscus injury, 26.7% (4 / 15) with synovial cyst, 20.0% (3 / 15) with synovial thickening and 6.7% (1 / 15) with synovial chondromatosis. Conclusion LA of knee joint has characteristic morphological signal changes on MRI, LA is one of the factors causing osteoarthritis.
【作者单位】：浙江大学医学院附属邵逸夫医院放射科;仙居县人民医院放射科;
【分类号】：R684;R445.2

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