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Pigmented villonodular synovitis: MR imaging in pediatric patients
Boris P Eckhardt1, Ramiro J Hernandez
1Department of Radiology, C. S. Mott Children's Hospital, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0252, USA. borise@med.umich.edu
Pediatric Radiology
|September 28, 2004
Summary
Gradient-echo and contrast-enhanced MRI are useful for diagnosing pediatric pigmented villonodular synovitis (PVNS). These techniques effectively assess disease extent, particularly identifying masses posterior to cruciate ligaments without bony abnormalities.
Area of Science:
- Radiology
- Pediatric Imaging
- Musculoskeletal MRI
Background:
- Pigmented villonodular synovitis (PVNS) is a rare neoplastic condition affecting the synovium.
- Accurate diagnosis and staging are crucial for effective management in pediatric patients.
Purpose of the Study:
- To evaluate the utility of gradient-echo (GRE) and contrast-enhanced magnetic resonance imaging (CE-MRI) for diagnosing and assessing PVNS extent in children.
- To compare the effectiveness of GRE and CE-MRI with conventional MRI sequences.
Main Methods:
- Retrospective analysis of five pediatric patients diagnosed with PVNS of the knee.
- Comparison of signal characteristics across T1-weighted, proton-density (PD)-weighted, GRE, and CE-MRI sequences.
- Correlation of imaging findings with arthroscopic assessment of disease extent.
Main Results:
- GRE imaging demonstrated superior depiction of disease extent compared to PD- and T1-weighted imaging due to signal decay (T2*-effect) in hemosiderin-laden synovium.
- CE-MRI effectively identified inflamed synovium with low hemosiderin deposition.
- Commonly involved areas included the suprapatellar bursa, Hoffa's fat pad, and the region posterior to the cruciate ligaments. No bony abnormalities were observed.
Conclusions:
- Gradient-echo imaging combined with contrast-enhanced MRI is valuable for diagnosing and assessing the extent of PVNS in pediatric knee joints.
- A low signal mass located posterior to the cruciate ligaments is a significant diagnostic indicator.
- The absence of bony abnormalities is a consistent finding in pediatric PVNS.