膝关节滑膜血管瘤临床特征诊断和治疗.docVIP

膝关节滑膜血管瘤临床特征诊断和治疗 　　【摘要】 目的 探讨膝关节滑膜血管瘤的临床特征、诊断和治疗。方法 通过对5例经关节镜及病理证实为膝关节滑膜血管瘤患者的随访观察，分析其临床表现、彩色多普勒超声及核磁共振的特点，并观察关节镜在滑膜血管瘤诊断和治疗中的作用。结果 疼痛是膝关节滑膜血管瘤的主要表现，但由于疼痛无特异性，临床诊断困难。彩色多普勒超声及核磁共振检查均可发现膝关节内血流丰富的肿块，关节镜下肿瘤表现为增生、扩张、迂曲的血管团。关节镜下肿瘤切除术后随访6~24个月，疼痛症状消失，关节功能恢复良好。结论 彩色多普勒超声和核磁共振有助于滑膜血管瘤的术前诊断，关节镜检查结合组织活检是确诊本病的重要手段，但要提高早期诊断率，加强对本病的认识是关键，关节镜下肿瘤切除是滑膜血管瘤治疗的有效方法，且镜下手术具有创伤小，并发症少，不影响关节活动等优点。 　　【关键词】 滑膜血管瘤；诊断；治疗 　　 　　Clinical manifestations,diagnosis and treatment of synovial hemangioma of the knee 　　 　　HUANG Dong-mei,CAI Dao-zhang,REN Jie,et al.Department of Ultrasound,Department of Orthopaedic Surgery,the Third Affiliated Hospital,Sun Yat-sen University,Guangzhou Guangdong Province 510630,China 　　 　　【Abstract】 Objective To evaluate the Clinical manifestations,diagnosis and treatment of synovial hemangioma.Methods 5 cases with synovial hemangioma of the knee who were confirmed by arthroscopy and tumor biopsy were analyzed to study Clinical manifestation,imaging features of colour Doppler and MRI of those patients.Results Since synovial hemangioma has no specific clinical manifestation,early diagnosis was very difficult.Both MRI and color Doppler yielded specific findings.that indicated synovial hemangioma.The arthroscopic finding was masses that made of dilated and circuitous blood vessels on the synovium.The results of all cases showed to be excellent after arthroscopic excision of the tumor.Conclusion MRI and color Doppler were helpful in the preoperative diagnosis of synovial hemangioma.Arthrosopy was a useful and effective method in the diagnosis and treatment of synovial hemangioma.Comparing to open surgery arthroscopy has many advantages such as less trauma,less complications,no morbidity to joint function. 　　【Key words】 Synovial hemangioma；Diagnosis；Treatment 　　 　　关节内滑膜血管瘤是一种少见疾病，由于其无特异性临床表现，容易误诊，近年来随着影像技术如核磁共振成像和彩色超声的广泛应用和关节镜技术的开展，报道有所增加，到目前为止国内报道了近30例。我院自开展关节镜术以来，行关节镜检查和各类镜下手术3 000余例，经关节镜及病理确诊为滑膜血管瘤者5例，结合文献报告如下。 　　 　　1 资料和方法 　　 　　1．1 临床资料 经关节镜及病理确诊为滑膜血管瘤者5例，其