摘要
目的归纳腓肠肌-半膜肌滑囊滑膜骨软骨瘤病(SO-GSB)的X线平片、CT、MRI、超声表现,并进行影像方法的比较。方法对15个SO-GSB在术前进行X线平片、CT、MR、超声检查,并对影像资料进行对比研究。结果 15个术后病理均证实为SO-GSB,其中单独发生于GSB 9个,合并关节腔者6个。X线平片(15个):膝关节内后方见堆积状或簇状、边缘光滑的类圆形结节,其中9个见钙质结节,7个见环弧状钙质结节伴中心脂肪髓密度。CT检查(9个):GSB扩张积液(9个)、滑膜不均匀性增厚(4个)及多个边缘光滑的类圆形结节,其中6个见钙质结节,5个见环弧状钙质结节伴中心脂肪髓密度,3个见中等密度结节。三维重建图像能更直观地显示钙化结节的数量、大小、形态、位置。MR检查(8个):GSB扩张积液(8个)、滑膜不均匀性或结节性增厚(5个)及多个边缘光滑的类圆形结节,其中5个见混杂低信号结节,5个见脂肪髓信号结节,4个见软骨信号结节。还能够同时发现关节囊内的结构损伤。超声检查(15个):GSB扩张积液(15个)、滑膜不均匀性或结节样增厚(12个),其中13个见边缘较光滑的类圆形高-强回声团、弧形强回声并伴声影或中等回声结节内见斑点、团块状强回声结节,5个见滑膜内有较小低回声结节。不同类型结节常合并存在。结论 X线平片、CT、MRI、超声诊断SO-GSB各有优缺点,超声与X线平片(或CT)联合应用,可以同时显示钙化结节和软骨结节,用较低的费用获得最多的诊断信息,而MRI主要用于合并外伤的复杂病例。
Objective To summarize the manifestations of X-ray, CT, MRI and ultrasound of synovial osteochondroma- tosis of gastrocnemius-semimembranosus bursa （SO-GSB） and to compare the imaging diagnostic methods. Methods A controlled study was made in patients with SO-GSB proved by postoperative pathology and the characteristics of different imaging modalites in terms of X-ray, CT, MRI and ultrasound were summarized in this work. Results Of thsese15 cases of SO-GSB, 9 occurred alone in the knees and 6 merged into the articular cavity. X-ray （15 knees） showed that round nodules, which were heaped-up or cluster, with smooth edge appeared in intra-pone knee joint, of which 9 presented with calcification, 7 with ring campylodromous calcium density and central medulla density. CT （9 knees） showed that GSB appeared dilatation and edema in 9 knees, synovium ununiformity thickening in 4 knees, and multiple round nodules, of witch 6 presented with calcium nodules, 5 with ring campylodromous calcium density and central medulla density, and 3 with moderately density. Three-dimensional reconstruction can intuitively show the quantity, size, shape, location. MR （8 knees） showed that GSB appeared dilatation and edema in 8 knees, synovium ununiformity or nodosity thickening in 5 knees, and multiple round nodules, of which 5 presented with low signals, 5 with fatty marrow signals, 4 with cartilage signals. At the same time, we can see structure injury in intra-capsula. Ultrasound （15 knees） showed that GSB appeared dilatation and edema in 15 knees, synovium ununiformity or nodosity thickening in 12 knees, of witch 13 presented with slickness edge and round high-strong echo mass, arc strong echo with sound shadow or medium echo with spot bolus strong echo, 5 with low echo nodus in synovium. Frequently, different types of nodules were coexistent. Conclusion Four imaging methods have advantages and disadvantages in diagnosing the SO-GSB, Combining ultrasound with X-ray or CT could display classic nodules and cartilage nodules, which would get more diagnostic information with fewer expenses.Therefore, MRI should be used to diagnose complicated cases with traumatic injuries.
出处
《医学影像学杂志》
2013年第10期1616-1620,共5页
Journal of Medical Imaging
