色素沉着绒毛结节性滑膜炎与腱鞘巨细胞瘤的MRI特征及鉴别诊断  

MRI diagnosis and differential diagnosis of pigmented villonodular synovitis and giant cell tumor of tendon sheath

作　　者：杨小红 李博雅[1] 李明智[1] 聂思 汪超雄 桂绍高[1] YANG Xiaohong;LI Boya;LI Mingzhi;NIE Si;WANG Chaoxiong;GUI Shaogao(MRI Room,the People’s Hospital of Jiangxi,Nanchang 330006,China;Department of Radiology,Anyi County People’s Hospital,Anyi,Jiangxi Province 330500,China)

机构地区：[1]江西省人民医院磁共振室,江西南昌330006 [2]安义县人民医院影像科,江西安义330500

出　　处：《实用放射学杂志》2019年第3期426-429,共4页Journal of Practical Radiology

摘　　要：目的分析色素沉着绒毛结节性滑膜炎(PVNS)和腱鞘巨细胞瘤(GCTTS)的MRI表现,提高对2种病变的诊断水平。方法回顾性分析经手术病理证实的10例PVNS和20例GCTTS的MRI资料。结果 10例PVNS中发生于膝关节8例,足部2例;弥漫型5例,局限型5例;与肌肉信号对比,增生滑膜T1WI呈等信号,T2WI呈等稍高信号,其内结节状T1WI、T2WI低信号影。20例GCTTS中18例局限型,2例弥漫型;发生于膝关节3例,手部与足部关节各8例,肩关节1例;20例GCTTS中结节状11例,不规则状9例;肿块T1WI呈等低信号,T2WI大部分呈低信号。结论 PVNS与GCTTS的MRI信号既有一定重叠又有差异,结合发病部位、病变形态学及MRI信号,能够提高两者的诊断符合率。Objective To analysis and comparison MRI manifestations of the pigmented villonodular synovitis ( PVNS) and giant cell tumor of tendon sheath (GCTTS),and further to improve the diagnostic accuracy of them.Methods 10 patients with PVNS and 20 patients with GCTTS confirmed by operation and pathology were analyzed retrospectively.All patients were examined with MRI. Results Among 10 cases of PVNS, 8 cases were located in knee joint, 2 in foot. 5 cases showed diffuse form, others showed focal form.Compared with the signal of skeletal muscle, the proliferative synovial appeared as isointensity on T1WI, mainly isointensity or slight hyperintensity on T2WI.Nodular hypointensity of T1 and T2 signal were seen within the synovial membrane. Among 20 cases of GCTTS, 18 were localized lesions,2 were diffuse lesions.There were 3 cases in knee joint,8 cases in hands and feet respectively, 1 case in shoulder joint. Among 20 cases of GCTTS, 11 cases were nodular lesions, 9 cases were irregular-shaped. The lumps appeared as isointensity or hypointensity on T1WI ,and most of them were slight hypointensity on T2 WI.Conclusion The MRI signal of PVNS and GCTTS have overlapping and difference.The location,morphology of lesions combined with MRI findings can improve the diagnostic accuracy of them.

关 键 词：色素沉着绒毛结节性滑膜炎 腱鞘巨细胞瘤 磁共振成像 

分 类 号：R686[医药卫生—骨科学] R445.2[医药卫生—外科学]