四肢肌内异位腱鞘囊肿的MRI诊断.docVIP

四肢肌内异位腱鞘囊肿的MRI影像特征与诊断 *吴鹏 刘培俊 (南华大学附属南华医院放射科 湖南 衡阳421002) [摘要] 目的:探讨四肢肌内异位腱鞘囊肿的MRI影像特征与病理，提高其MRI诊断准确性。方法：分析33例经我院病理证实的四肢肌内异位腱鞘囊肿的临床和MRI资料。结果：膝部24例、肘部4例、腕部3例、踝部2例，均呈长T1长T2信号，T2STIR呈高信号，未侵犯邻近骨骼与关节。其中10例病灶见边缘“云絮”状或“花边”状水肿信号，27例病灶内见低信号分隔带；钆喷替酸葡胺（Gd-DTPA）增强，整个病变无强化。结论：光整无强化的囊样病灶及病灶内均匀一致的窄飘带状无强化低信号分隔带是四肢肌内异位腱鞘囊肿的特征性表现。 [关键词]：腱鞘囊肿，四肢肌，MRI，病理，飘带状 MRI Imaging characteristic and diagnosis of Ectopic Ganglion in Limb Muscle *Wu Peng Liu Pei jun (Department of Radiology，Nanhua Hospital Affiliated of Nanhua University, Hengyang, Hunan421002) [Abstract] Objectives: To discuss the MRI imaging characteristic and pathology of ectopic ganglion in limb muscles and improve the MRI diagnostic accuracy. Methods: The clinical and MRI imaging data of 33 cases with ectopic ganglion in limb muscles confirmed by pathology in our hospital were analyzed. Results: There were 24 cases in knees, 4 cases in elbows, 3 cases in twists, 2 cases in ankles, all of them had long T1 and long T2 signal, and T2STIR showed high signal , without invading joints and bones. 10 cases showed that lesions had “cloud flocculation” or lace-like edema signal ,and another 27 cases showed separations of low signal, which had no enhancement in Gd-DTPA enhanced MRI. Conclusion: MRI scanning showed no enhancement in the cystic lesions and no-enhancement low separations presenting the shape of the uniformity narrow float-ribbon , which were the characteristic manifestation of ectopic ganglion in limb muscles. [ Keywords]: ganglion, limb muscles, MRI, pathological, streamer. 四肢肌内异位腱鞘囊肿是一种少见的限局于四肢大关节附近肌肉内的良性病变，常被误诊为其它疾病。笔者结合四肢肌内异位腱鞘囊肿的病理基础、临床表现和MRI影像特点进行综合分析，提高认识，减少误诊；为临床制定合理的治疗方案提供依据。 1 资料与方法 临床资料 本文收集了2005年12月至2011年5月经本院病理证实的四肢肌内异位腱鞘囊肿33例，其中男18例，女15例，年龄20岁-55岁，中位年龄33.5岁；发病时间为1月至6年不等，均以发现肿块为主诉，5名患者偶有疼痛感。体格检查：16例肿物有压痛，5例肿物局部隆起。本组33例患者均无明显皮肤红、肿、热、皮肤溃烂、皮肤色素沉着及关节活动障碍等体征。 1.2 MRI检查 设备为SIGNA EXCITE 0.35T GEMS，扫描参数为：视野16cmⅹ14cm，层厚4mm，层距1mm，矩阵256ⅹ224，3NEX；行横轴位、冠状位、矢状位扫描，获取自旋回波平扫图像，病灶处加扫脂肪抑制及液体衰减反转恢复系列，在T1WI序列上增强；对比剂为Gd