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題 名 | Lipoma Arborescens on MR Imaging and the Associated Lesions: A Review of 78 Cases=樹狀關節脂肪瘤之磁振造影表現及相關病灶:七十八病例之回顧 |
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作 者 | 林政遠; 邱正民; 林宗慶; 李順龍; 沈家億; 陳友強; | 書刊名 | 臺灣復健醫學雜誌 |
卷 期 | 41:2 2013.06[民102.06] |
頁 次 | 頁93-104 |
分類號 | 416.61 |
關鍵詞 | 樹狀關節脂肪瘤; 磁振造影; 滑膜; 關節病變; Lipoma arborescens; MR imaging; Synovium; Joint pathology; |
語 文 | 英文(English) |
中文摘要 | 目的:識別樹狀關節脂肪瘤於磁振造影上之不同形態表現及相關病灶,並探討其臨床意涵。方法:本研究收集共78個樹狀關節脂肪瘤之案例,並回顧其影像表現及病歷紀錄。其中包括73個位於膝關節及5個肩關節之案例。2個案例經病理檢查確定診斷,其餘76個案例為磁振造影診斷。結果:所有案例於磁振造影上皆表現出典型之滑膜脂肪性增生,其中38%呈現典型之樹枝狀型態,41%為腫塊狀表現,另10%混合此兩種表現。樹狀關節脂肪瘤於膝關節內之相關病灶包括:關節積液(97%)、後十字韌帶損傷(69%)、前十字韌帶損傷(43%)、退行性變化(40%)、骨髓水腫(34%)、半月軟骨損傷(32%)、滑膜囊腫(15%)、內側韌帶損傷(13%)、軟骨破損(12%)、軟骨瘤病(6%)、臏骨半脫位(4%)及圓盤狀半月板(4%),除兩位案例外,所有案例皆伴隨相關病灶;5個肩關節案例之相關病灶包括:旋轉肌撕裂傷(100%)、關節積液(100%)、退行性變化(80%)、肱二頭肌長頭腱鞘炎(40%)及可能之沾黏性關節囊炎(40%)。所有案例之樹狀關節脂肪瘤表現皆為意外發現。當中只有兩位接受關節鏡滑膜切除術,但後續皆有症狀復發之情形。結論:樹狀關節脂肪瘤雖為罕見病灶,其磁振造影上之特有形態表現可提供正確及早期之診斷。本研究之結果顯示關節創傷後或退化性關節炎皆可能導致此病灶之形成。及早的介入治療應有助於關節損傷之復原及避免症狀進展及惡化。 |
英文摘要 | Objective: To identify the different morphologic patterns of lipoma arborescens (LA) and the associated lesions on magnetic resonance (MR) imaging and to evaluate their clinical implication.Methods: We conducted a retrospective review of the MR images and medical records of 78 patients diagnosed with LA of the knee (n=73) and shoulder (n=5). The diagnosis of LA was confirmed by the histologic findings in two cases and by the characteristic MR imaging features in the other 76.Results: A typical pattern of villous lipomatous proliferation of the synovium was identified on MR imaging in all cases, as a typical frond-like pattern in 38% (30/78) of cases, a dominant mass-like lesion in 41% (32/78) of cases and mixed type presentation in 21% (16/78) of cases. The associated MR lesions in the knee (n=73) were: joint effusion (97%), posterior cruciate ligament tear (69%), anterior cruciate ligament tear (43%), degenerative changes (40%), bone marrow edema (34%), meniscal tear (32%), synovial cysts (15%), medial collateral ligament tear (13%), osteochondral defect (12%), chondromatosis (6%), patellar subluxation (4%) and discoid meniscus (4%). All cases except two had associated pathologies of the knee. The associated MR pathologies in the shoulder (n=5) were: rotator cuff tear (100%), joint effusion (100%), degenerative changes (80%), subcromial enthesophyte (80%), biceps tendon tenosynovitis (40%) and probable adhesive capsulitis (40%). LA appeared to be an incidental diagnosis in all cases. The two cases of LA of the knee managed by synovectomy reported symptomatic recurrence.Conclusion: The pathognomonic appearance of LA on MR imaging provides for a precise and early detection of this uncommon lesion. Trauma, degenerative or inflammatory conditions may predispose a joint to this synovial disorder. Early intervention may be crucial for proper healing and avoidance of joint deterioration. |
本系統中英文摘要資訊取自各篇刊載內容。