四肢肌内异位腱鞘囊肿的MRI诊断_临床医学论文.docVIP

四肢肌内异位腱鞘囊肿的MRI诊断_临床医学论文 四肢肌内异位腱鞘囊肿的MRI诊断_临床医学论文 作者：文星 伍小芳 肖立华 彭小虎　周昆鹏 熊统生 【摘要】 目的 探讨四肢肌内异位腱鞘囊肿的临床和MRI特点，为临床提供正确的影像学诊断。 方法 回顾性分析和总结53例经病理证实的四肢肌内异位腱鞘囊肿的临床和MRI资料。 结果 32例肌内异位腱鞘囊肿位于膝部，9例发生于肘部，7例发生于肩部，5例发生于踝部；45例位置深在，8例位置表浅；均呈长T1长T2信号， 24例可见病灶缘“云絮”状或花边状高信号，43 例可见病灶内低信号分隔影；增强扫描中，低信号分隔影及囊性部分、囊壁无强化。均未侵犯邻近骨骼。 结论 囊性病灶中出现均匀一致的窄飘带样无强化低信号分割带及具有光整无强化的囊壁是诊断四肢大关节附近肌内异位腱鞘囊肿比较可靠的征象。 【关键词】 四肢; 磁共振成像; 囊肿; 粘液样 [Abstract] Objective To discuss the clinical and MR imaging feathures of misplaced cyst in extremitis muscle and to provide MR diagnosis for clinical. Methods Clinical and MR imaging data of fifty-three patients with histdogically confirmed misplaced cyst in musclc were retrospectively amalyzedamd studied. Results Thirty-two cysts occurrred in knee, nine in elbow, seven in shoulders, five in ankle.Fourty-five tumors were situated deeply and eight were superficial. All tumors showed long T1-weighted imaging and long T2-weighted imaging with having amorphous foci, linear of high signal intensity and owning low signal septa cine in tumors.Following the injection of Gd-DTPA, low signal lace showed slightly enhancement and cyst wall showed no enhancement. Adjacent bones were not been invased in fifty-three cases. Conclusion It is comparably accurant speciality that there are homogenous, narrow motive low signal septa with and absees smoothy cyst wall with no enhancement in the cyst tumors. [Key words] extremities; Magnetic resonance imaging; cyst; myxoid 四肢肌内异位腱鞘囊肿是一种不常见的局限于关节附近肌肉内的良性病变，以往常误诊为其他疾病。随着磁共振成像仪(Magnetic Resounce Imaging)在骨关节系统检查的广泛应用，文献上对腱鞘囊肿及骨内腱鞘囊肿的报道增多[1]，但未见有关异位于肌肉内囊肿的报道。笔者结合四肢肌内异位腱鞘囊肿病理基础对其临床和MRI特点进行了探讨，以期减少误诊，提高四肢肌内异位腱鞘囊肿MRI诊断准确率，避免手术或最大限度减少患者遭受扩大手术范围之苦。 材料与方法 1.一般资料 搜集2000年5月至2007年8月53例解放军一六九中心医院及解放军总医院、南方医科大学附属南方医院经病理证实为四肢肌内异位腱鞘囊肿患者并对其临床和MRI资料进行回顾性分析总结，其中男38例，女15例，年龄22～57岁，中位年龄35.5岁。 2. 扫描设备及参数 MRI检查设备为Siemens Magneton Vision 1.5T、Siemens Magnetom C 0.35T MRI仪，视野(Fov)16cm×14cm，层厚4mm，层距1mm，矩阵256×224，3NEX，行横轴位、冠状位、矢状位扫描，获取自旋回波平扫和增强T1WI图像，病灶处加扫脂肪抑制及液体衰减反转恢复系列，增强扫