色素沉着绒毛结节性滑膜炎的MRI表现..pptVIP

Pigmented Villonodular Synovitis (PVNS)色素沉着绒毛结节性滑膜炎 Introduction Pigmented villonodular synovitis (PVNS) comprises a group of idiopathic lesions in joints,tendon sheathes and bursae. (色素沉着绒毛结节性滑膜炎主要是指关节、滑囊以及腱鞘内的滑膜特发性的呈结节状或绒毛状进行性增生。) Pigmented vilionodular synovitis (PVNS) is an uncommon, usually monoarticular disorder and usually found in adults. The most common sites predilection is knee-joint(80%),then the hip ,ankle, shoulder, elbow in turn. (不常见，好发于成年人，生于膝关节, 占80 % ,髋关节、踝关节、肩关节、肘关节的发病率依次减少) Clinical manifestations The clinical manifestations is lack of specificity. The main manifestations are progressive swelling of joints and hemorrhagic joint effusion. It shows recurrent joint effusions, which can be misdiagnosed as arthritis. Episodes of complete remission may be found between periods of active disease. (本病的临床表现缺乏特异性.临床主要表现为受累关节进行性肿胀,血性关节积液较常见，本病可引起反复积液，各活动期之间可见病变发作的缓解。) The cause of PVNS is not clear, maybe related with tumor、trauma and infection. (本病的病因尚不明,一般认为与肿瘤、外伤、感染有关。) Diagnosis：imaging findings X-ray: the routine X-ray shows major symptoms including joint capsule swelling , soft tissue mass in periphery of joint and invasion of bone which edge shows ossified ring, but joint space is normal, no osteoporosis . X 线表现: 常规X 线平片上主要征象包括关节囊肿胀、关节周围软组织肿块及邻近骨骼的侵蚀,骨缺损边缘有硬化环,但关节间隙保持正常,无骨质疏松 Diagnosis：imaging findings CT findings: shows joint capsule swelling, thickened synovium and obvious joint effusion CT 表现: 表现为关节囊肿胀,滑膜增厚,关节腔内明显积液 Diagnosis：imaging findings MR findings is very special and shows thickened synovitis and the condition of joint effusion. MRI 表现具有明显的特征性，能清晰的显示滑膜的增厚和积液的程度。 Because of hemosiderin deposition in the synovitis lesions, it shows low signal both on T1WI and T2WI. Partial lesions show bone invasion. 由于病变滑膜组织内含铁血黄素的沉积，故在T1加权像和T2加权像均呈低信号，这是特征性的征象。部分病变可侵蚀骨结构。 Histology and Pathology(组织病理学) The histological findings are exuberant synovial proliferation with n