手足局限性腱鞘巨细胞瘤的MRI表现  

MR Imaging Manifestations of Localized Giant Cell Tumour of Tendon Sheath in Extremities

作　　者：艾松涛[1] 孙明华[1] 余强[1] 王平仲[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院放射科,200011

出　　处：《放射学实践》2008年第5期543-546,共4页Radiologic Practice

摘　　要：目的：探讨手足腱鞘巨细胞瘤的MRI表现特点。方法：回顾性研究分析8例手足腱鞘巨细胞瘤的MR影像资料，所有病例均于MRI检查后行手术病理诊断。所有病变均先行常规MRI扫描，其中6例作增强扫描，4例行动态增强扫描，2例行^1H—MRS检查。结果：8例腱鞘巨细胞瘤中7例T1WI上呈均匀等信号，1例呈不均匀等高信号；1例T2WI上呈不均匀高信号，7例呈不均匀中等高信号；Gd-DTPA增强MRI上，4例呈中等程度不均匀强化，2例明显均匀强化。动态MRI扫描显示：4例腱鞘巨细胞瘤TIC表现为Ⅱ型曲线，在15～30s间可见平缓上升。^1H—MRS扫描显示：2例腱鞘巨细胞瘤具有高而宽大的Lip波峰，Cho峰较小。结论：手足腱鞘巨细胞瘤的MRI信号表现为T1WI上的等信号和T2WI上的不均匀等、高信号，与典型的色素绒毛结节性滑膜炎和硬纤维瘤的MRI表现有所不同。临床表现、动态MRI增强扫描、^1H—MRs和常规MRI的综合表现有助于手足腱鞘巨细胞瘤鉴别诊断。Objective：To evaluate the MRI appearances of localized giant cell tumour of tendon sheath （GCTTS） in extremities. Methods：Routine MR images of 8 patients with surgery and pathology proved GCTTS were retrospectively reviewed. T1 and T2 weighted imaging were carried out in all of the 8 patients. Six patients had enhanced MRI,Four patients had dynamic contrast-enhancement and 2 patients had ^1H-MR spectroscopy. Results：The MR signal intensities of the localized GCTTSs were homogeneously iso-intense （n= 7） and heterogeneously iso-/hyper intense （n= 1） on T1 weighted images ; heterogeneously moderate/hyper intense （n= 7） and heterogeneously hyper-intense （n= 1） on T2 weighted images. The signal intensities tended to be moderately and heterogeneously enhanced （n= 4） and markedly homogeneously enhanced following Gd-DTPA administration. The time-intensity-curve showed as type Ⅱ which ascended slowly in 4 lesions on dynamic contrast enhanced images. On ^1H-MRS, the peak of Lip was high and broad and that of Cho was low. Conclusion： MR imaging of GCTTS showed homogeneous iso-intensity on Tt WI and heterogeneous hyper-intensity on T2 WI,which was different from that of typical pigmented villous nodular synovitis and desmoid. These characteristic MR features together with clinical information provided valuable information for the diagnosis of GCTTS before operation.

关 键 词：腱鞘 巨细胞瘤 局限性 磁共振成像 诊断 

分 类 号：R738[医药卫生—肿瘤]