目的 探讨膝关节色素沉着绒毛 结节性滑膜炎(Pigmented villonodular synovitis,PVNS)核磁共振成像技术(MRI) 影像学特征与病理特征之间的关系。方 法 回顾性分析2014年1月-2017年1月我院 收治的21例经手术病理或者关节镜证实为 PVNS患者的MRI影像学及病理学资料，分 析PVNS MRI影像学特征与临床病理特点之 间的关系。结果 21例PVNS中，弥漫型者 17例，局限型者4例，PVNS病理表现为关 节滑膜出现不规则弥漫或者结节状增生， 可见丰富血管及结节内大量含铁血黄素沉 着，邻近半月板或(和)骨侵蚀以及关节腔 积液等；MRI影像学表现：所有患者均可 见不同程度的关节内积液，其中弥漫型17 例，关节滑膜呈现弥漫性结节样增厚， T2WI呈现稍高信号，T1WI呈现低信号，增 生结节内可见小结节状或者点状T2WI呈现 低信号，T1WI呈现等低信号；2例可见增 生滑膜明显强化，可见结节内呈点片状无 强化区；15例可见髌骨下脂肪垫受侵，髌 下脂肪垫呈现不规则形态；8例可见膝关 节关节面软骨破坏；局限型4例，可见滑 膜及腱鞘与团状软组织信号关系密切，软 组织信号可见T1WI、T2WI呈点片状低信号 影。结论 MRI技术可特征性反映PVNS病理 基础，在诊断PVNS方面具有较高的应用价 值。

Objective To investigate the relationship between MRI findings and clinical pathological features of pigmented villonodular synovitis of the knee. Methods MRI and pathological data of 21 patients with PVNS in our hospital from 2014 to 2017 in January were retrospectively analyzed, and the relationship between MRI features and clinical pathological features was analyzed. Results Among 21 cases of PVNS, there were diffuse type in 17 cases, and localized type in 4 cases. The pathological features of PVNS showed irregular diffuse or nodular hyperplasia of the synovial membrane, which could be seen in the presence of a large number of blood vessels and nodules containing a large number of blood stasis, adjacent meniscus or (and) bone erosion and joint effusion. MRI imaging: all patients showed different degrees of intra-articular effusion, 17 cases of diffuse type, and synovium showed diffuse nodular thickening. T2WI showed slightly higher signal, T1WI showed low signal, hyperplasia nodules showed nodular or punctate T2WI showed low signal, T1WI showed low signal. 2 cases showed obvious enhancement of synovial hyperplasia, and visible nodules showed patchy no enhancement area. 15 cases of patella fat pad invasion, the infrapatellar fat pad showed irregular morphology. 8 cases of knee joint articular cartilage damage. 4 cases of localized type, visible synovium and tendon sheath and nodular soft tissue signals were closely related soft tissue, and T1WI and T2WI showed visible signs of patchy low signal intensity. Conclusion MRI can reflect the pathological basis of PVNS, and it has high application value in the diagnosis of PVNS.