Pigmented Villonodular Synovitis of the Temporomandibular Joint-MR and CT Features

本篇報告一個色素性絨毛結節狀滑膜炎發生在顳骨下頷關節的病例。這個22歲男性有兩年的左耳前腫痛的病史，X光發現左關節盂的破壞。斷層掃描發現左顳骨下頷關節有一腫塊並延伸到左顥骨下凹及下頷骨外側，並且造成關節盂的骨腐蝕。在使用顳骨下頷關節線圈的磁振造影上，這腫塊表現在T1WI和T2WI上高低摻雜的訊號，其中有相當低訊號點狀區域代表血鐵質沉積。開刀前就診斷為色素性絨毛結節狀滑膜炎。據我們所知，這樣的病例在英文文獻上約有21例，其中只有二人在開刀前接受磁振造影檢查（用一般頭部線圈）。這是第一個在開刀前接受用顳骨下頷關節線圈的磁振造影檢查的病例，這種檢查技術使得開刀前可診斷出顳骨下頷關節的色素性絨毛結節狀滑膜炎，並對手術範圍評估有很大幫忙。

關鍵字

滑膜炎；關節，顳骨下頷關節；斷層掃描；磁振造影

並列摘要

A case of pigmented villonodular synovitis (PVNS) of the left temporomandibular joint (TMJ) is described. This 22-year-old male had frequent left preauricular pain and swelling for 2 years. Panoramic radiograph showed extensive destruction of the left glenoid fossa. Computed tomography revealed a mass in the TMJ region which extended to the infratemporal fossa and lateral aspect of the left mandibular condyle. Widening of the joint space and erosion of the glenoid fossa were also noted. Magnetic resonance imaging (MRI) using a TMJ surface coil showed a mass occupying the left TMJ with both intraarticular and extraarticular extensions. The mass showed mixed low and high signal intensities (SI) on T1-weighted (T1WI) and T2WI images. Multiple areas of dark SI were seen in the mass on all pulse sequences indicating hemosiderin deposition. A preoperative diagnosis of PVNS was correctly made. PVNS involving the TMJ is rarely encountered. To the best of our knowledge, while 21 such cases have been reported in the English literature, only 2 of them were examined with MRI using a standard head coil. This is the first reported case to undergo preoperative MRI study with a TMJ coil. MRI using a TMJ coil made the preoperative diagnosis of PVNS possible and was of great help in the evaluation of the lesion extension and surgical planning.

並列關鍵字

Synovitis ； Joints, temporomandibular joint ； Computed tomography ； Magnetic resonance imaging

國際替代計量

Pigmented Villonodular Synovitis of the Temporomandibular Joint-MR and CT Features

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