腱鞘巨细胞瘤的影像表现特征  

Imaging findings of giant cell tumor of tendon sheath

作　　者：李斌[1,2] 王超[1] 张敏鸣[1] 

机构地区：[1]浙江大学医学院附属第二医院放射科,杭州310009 [2]杭州市余杭区第一人民医院放射科,311100

出　　处：《中华放射学杂志》2015年第6期454-457,共4页Chinese Journal of Radiology

摘　　要：目的：探讨腱鞘巨细胞瘤（GCTTS）的影像表现特征。方法回顾性分析39例经手术和病理证实的GCTTS患者X线、CT、MRI影像资料。39例患者中，局限性32例、弥漫性7例；17例行X线平片检查，18例行CT平扫检查，37例行MRI平扫，其中17例行MRI增强扫描。3名从事影像诊断的副主任医师对图像共同进行分析。结果 X线平片显示GCTTS多为关节旁软组织肿块，邻近骨质呈不同程度侵蚀、破坏（10/17），均无明显钙化征象及骨膜反应。CT显示软组织肿块和骨质改变较X线片清晰，部分软组织肿块呈分叶状跨关节生长（8/18）,可见邻近骨质压迫吸收、侵蚀性改变（11/18），均无明显钙化征象及骨膜反应。MRI表现为病灶在T1WI多呈等信号（32/37），T2WI多呈高信号（27/37），增强后多呈不均匀明显强化（14/17），病灶均与邻近肌腱关系密切。结论 GCTTS的影像表现具有一定的特征性。MRI能够反映GCTTS的内部信号特征及与邻近组织的关系，对诊断、指导临床治疗和随访具有重要价值。Objective To explore the imaging features of giant cell tumor of tendon sheath（GCTTS） so as to improve the accuracy of imaging diagnosis. Methods Thirty-nine cases of GCTTS confirmed by pathological examination were retrospectively analyzed.Of the 39 cases, 32 were diffuse form and 7 were localized form.Seventeen patients underwent X-ray examination,18 had CT pain examination,37 had pain MR imaging and 17 had contrast-enhanced MR imaging.Results X-ray showed local soft tissue masswith slightly high density, and the adjacent bones were shown destruction or erosion tovarious degrees（10/17）. No obvious calcification and periosteal reaction were shown.CT scans could provide images better than X-ray films.CT showed local soft tissue masses in the peri-articular muscle gaps. Some tumors were lobulated with cross-jointed growth（8/18）,and the adjacent bones were shown destruction or erosion tovarious degrees（11/18）.No obvious calcification and periosteal reaction were shown. On MRI,most cases were isointense on T1WI（32/37）,and hyperintense on T2WI（27/37）. Most cases tended to be heterogeneously enhanced following Gd-DTPA administration（14/17）.The lesions were typically located adjacent to a tendon or partially/completely encasing it. Conclusions The imaging findings of GCTTS have some certain characteristics. MRI is able to depict the characteristic internal signal of GCTT and its relationship with adjacent tissues, which is valuable for diagnosis, treatment and follow-up.

关 键 词：巨细胞瘤 体层摄影术 X线计算机 磁共振成像 诊断 

分 类 号：R738[医药卫生—肿瘤]