Posterior Cruciate Ganglion Cyst 后交叉韧带腱鞘囊肿

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1. What are some conditions that can cause this appearance?

   下图所示，哪些疾病可有类似的影像学表现？

2. Can these lesions cause osseous erosion?

这些病变会有骨质侵蚀么？

3. What is the most common presentation of a patient with this lesion?

该病最常见的临床表现？

4. How are these lesions treated?

该病应如何治疗？

Posterior Cruciate Ganglion Cyst

后交叉韧带腱鞘囊肿

1. Cruciate ganglion cyst, meniscal cyst, synovial cyst.

   交叉韧带腱鞘囊肿

2. Yes.

有可能发生骨质侵蚀。

3. Pain and limitation of the range of motion.

疼痛，活动受限。

4. Arthroscopic resection. Occasionally cysts may regress with conservative treatment.

治疗主要选择关节镜手术。保守治疗囊肿偶尔可吸收。

References

Kim RS, Kim KT, Lee JY, Lee KY: Ganglion cysts of the posterior cruciate ligament. Arthroscopy19:E36–E40, 2003.

Recht MP, Applegate G, Kaplan P, et al: The MR appearance of cruciate ganglion cysts: A report of 16 cases.Skeletal Radiol23:597–600, 1994.

Cross-Reference

Musculoskeletal Imaging: THE REQUISITES, 3rd ed, pp 244–246.

Comment

Extra-articularcysts arising about the knee joint are common and likely represent poplitealcysts, meniscal cysts, and ganglion cysts. Intra-articular cysts, however, areuncommon and most likely represent either meniscal cysts or ganglion cysts. Acruciate ganglion cyst is an unusual entity that presents as a well-defined,multilocular lesion arising from either the posterior or anterior cruciateligament. On T1W images, these cysts vary from hypo- to slightly hyperintensewith respect to the signal intensity of muscle. On T2W images, the majority ofcysts demonstrate homogeneously high signal intensity, although hemorrhage mayalter the signal characteristics of a particular lesion. The differential diagnosisis limited. Trapped joint effusion can be eliminated owing to the multilocularnature of the majority of posterior cruciate ligament lesions and the fusiform appearanceof anterior cruciate ligament lesions. Occasionally, a large intra-articularmeniscal cyst arising from the posterior horn of either meniscus can mimic thisganglion cyst but the presence of a large meniscal tear should be evident.

膝关节周围的关节外囊肿临床较常见，主要是腘窝囊肿、半月板囊肿、腱鞘囊肿。关节内囊肿临床较少见，一般是半月板囊肿或腱鞘囊肿。交叉韧带腱鞘囊肿较少见，一般表现为起源于前交叉韧带或后交叉韧带的，边界清楚的多房性囊性病变。T1WI上，囊肿相对应肌肉可呈低或稍高信号；T2WI上，尽管有时囊内可有出血，但大多数的囊肿表现为均匀高信号。

需要鉴别诊断的疾病不多。局限性关节积液可从形态上与本病鉴别，后交叉韧带腱鞘囊肿一般呈多房性，前交叉韧带囊肿一般呈梭形。起源于一侧半月板后角的较大的关节内半月板囊肿易与本病混淆，但前者伴有半月板撕裂可作为鉴别点。