CAJ | 학술논문

目的：比较原发性滑膜骨软骨瘤病(PSO)的X线平片、CT、MR1、超声4种影像方法诊断价值。方法对照研究手术及病理证实的42例（44个关节）PSO的X线平片、CT、MRI、超声影像资料及病理资料。结果 X线平片：软骨型结节均末显示，显示钙化型结节197枚（28个关节），骨化型结节96枚（24个关节），混合型结节5枚（3个关节）；36个关节正确诊断，准确率81.8％ (36/44)。CT检查：软骨型小结节未显示，显示软骨型大结节8枚（5个关节），钙化型结节255枚（30个关节），骨化型结节146枚（28个关节），混合型结节16枚（7个关节）；24个关节VR图像能更直观清晰地显示非软骨型结节的数量、大小、形态及位置；40个关节正确诊断，准确率90.9％（40/44）。MRI:显示软骨型大结节8枚（5个关节）,软骨型小结节70枚（4个关节），钙化型结节248枚（29个关节），骨化型结节146枚（28个关节），混合型结节16枚（7个关节）；在DWI上均呈低信号。增强扫描结节内无强化；43个关节正确诊断，准确率97.7％ (43/44)。超声检查：显示软骨型大结节8枚（5个关节），软骨型小结节70枚（4个关节），钙化型结节232枚（30个关节），骨化型结节142枚（28个关节），混合型结节16枚（7个关节）；43个关节正确诊断，准确率97.7％( 43/44)。结论 X线平片、CT、MRI及超声4种影像方法诊断PSO各有优缺点，应根据临床需要恰当选择，必要时可联合应用。
목적：비교원발성활막골연골류병(PSO)적X선평편、CT、MR1、초성4충영상방법진단개치。방법 대조연구수술급병리증실적42례（44개관절）PSO적X선평편、CT、MRI、초성영상자료급병리자료。결과 X선평편：연골형결절균말현시，현시개화형결절197매（28개관절），골화형결절96매（24개관절），혼합형결절5매（3개관절）；36개관절정학진단，준학솔81.8％ (36/44)。CT검사：연골형소결절미현시，현시연골형대결절8매（5개관절），개화형결절255매（30개관절），골화형결절146매（28개관절），혼합형결절16매（7개관절）；24개관절VR도상능경직관청석지현시비연골형결절적수량、대소、형태급위치；40개관절정학진단，준학솔90.9％（40/44）。MRI:현시연골형대결절8매（5개관절）,연골형소결절70매（4개관절），개화형결절248매（29개관절），골화형결절146매（28개관절），혼합형결절16매（7개관절）；재DWI상균정저신호。증강소묘결절내무강화；43개관절정학진단，준학솔97.7％ (43/44)。초성검사：현시연골형대결절8매（5개관절），연골형소결절70매（4개관절），개화형결절232매（30개관절），골화형결절142매（28개관절），혼합형결절16매（7개관절）；43개관절정학진단，준학솔97.7％( 43/44)。결론 X선평편、CT、MRI급초성4충영상방법진단PSO각유우결점，응근거림상수요흡당선택，필요시가연합응용。
Objective To compare the diagnostic value of X-ray, CT, MRI, and ultrasound in primary synovial osteochondromatosis ( PSO ). Methods The imaging data of X-ray, CT, MRI, and ultrasound of 42 patients with 44 knees with PSO proved by surgery and pathology were retrospectively collected and analyzed. Results The Plain X-ray demonstrated 197 calcific nodules in 28 joints, 96 ossific nodules in 24 joints, and 5 mixed type nodules in 3 joints. Compared with the data of surgery and pathology,36 joints (81.8 ％, 36/44) were diagnosed correctly by X-ray. The CT showed 8 big cartilaginous nodules in 5 joints, 255 calcific nodules in 30 joints, 146 ossific nodules in 28 joints, and 16 mixed type nodules in 7 joints. Twenty-four knees underwent volume rendering technique reconstruction which displayed the quantity, size, shape, and position of non-cartilaginous nodules clearly. Compared with the data of surgery and pathology, 40 joints (90. 9％ , 40/44)were diagnosed correctly by CT. The MRI demonstrated 8 big cartilaginous nodules in 5 joints, 70 small cartilaginous nodules in 4 joints, 248 calcific nodules in 29 joints,146 ossific nodules in 28 joints, and 16 mixed type nodules in 7 joints. All nodules displayed low signal in DWI and there was no enhancement. Compared with the data of surgery and pathology, 43 joints (97.7％,43/44) were diagnosed correctly by MRI. The ultrasound showed 8 big cartilaginous nodules in 5 joints,70 small cartilaginous nodules in 4 joints, 232 calcific nodules in 30 joints, 142 ossific nodules in 28 joints,and 16 mixed type nodules in 7 joints. Compared with the data of surgery and pathology, 43 joints (97. 7％,43/44) were diagnosed correctly by ultrasound. Conclusions The less common manifestations of the PSO require multimodality imaging to make the diagnosis. Multimodalities (X-ray,CT, MRI and ultrasound) are particularly useful in fully characterising PSO and to allow for appropriate clinical planning.