滑膜树枝状脂肪瘤影像学表现

发布时间：2018-04-23 06:30

本文选题：滑膜脂肪瘤病 + 膝关节　；参考：《中国医学影像技术》2015年07期

【摘要】：目的探讨滑膜树枝状脂肪瘤(LA)的影像及其病理特征。方法回顾性分析14例经手术病理证实为LA患者的影像及病理特征。对所有患者均行MR平扫,1例同时行MR增强扫描,3例行CT平扫,1例行数字X线摄影(DR)检查;均行病灶切除术,制做病理标本,并行HE染色。结果 MR平扫显示,14例滑囊积液,9例呈绒毛状或棕榈叶状,5例合并丘状和多丘状病灶;12例病灶主体附着于近骨面滑囊壁,2例附着于侧面囊壁;1例MR增强扫描示病灶表面线样强化。CT示2例膝关节髌上囊绒毛状或棕榈叶状低密度影;1例肩关节三角肌下囊绒毛状或棕榈叶状、丘状、并排多丘状低密度影,邻近肱骨骨质吸收。DR示1例膝关节髌上囊区密度增高。除滑囊积液外,仅2例无其他合并症。镜下显示,病变表面为正常(n=8)或轻度肥大(n=6)的滑膜细胞,中央区为大量成熟脂肪组织,伴扩张毛细血管、淋巴细胞和浆细胞浸润。结论关节LA具有特征性影像及病理学表现,术前影像检查有助于正确诊断。
[Abstract]:Objective to investigate the imaging and pathological features of synovial dendritic lipoma (LAA). Methods the imaging and pathological features of 14 patients with LA proved by operation and pathology were retrospectively analyzed. All patients were examined by Mr plain scan (1 case) and enhanced Mr scan (3 cases) by plain CT scan (1 case by digital radiography DRR), by excision of lesion, pathological specimen and HE staining. Results Mr plain scan showed that 14 cases of skid sac effusion were villous or palm-like in 5 cases with mound and multi-mound lesions 12 cases were mainly attached to the wall of skid sac near the bone surface 2 cases attached to the lateral wall of the cyst 1 case showed the disease on enhanced Mr imaging. Linear enhancement of focal surface. Ct showed 2 cases of supracrapatellar bursa or palm-leaf low-density shadow of knee joint, 1 case of shoulder joint deltoid muscle bursa villous or palm leaf shape, The proximal humeral bone resorption. Dr showed that the density of superior patellar capsule area of knee joint was increased in 1 case. Only 2 cases had no other complications except the fluid of skidding sac. The synovial cells on the surface of the lesion were normal or slightly hypertrophic, and the central area was a large amount of mature adipose tissue with dilated capillaries, lymphocytes and plasma cells. Conclusion Articular LA has characteristic imaging and pathological features, and preoperative imaging is helpful to correct diagnosis.
【作者单位】：青岛大学附属医院放射科;郑州市骨科医院放射科;山东大学齐鲁医院骨科;
【分类号】：R738.5;R445.2;R730.44

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