腱鞘巨细胞瘤超声表现与误诊分析  

Ultrasonographic features and misdiagnosis of giant cell tumors of tendon sheath

作　　者：魏瑶 袁宇[1] 高金妹[1] Wei Yao;Yuan Yu;Gao jin-mei(Department of Ultrasound,Tianjin Hospital,Tianjin 300211,China)

机构地区：[1]天津市天津医院超声科,300211

出　　处：《实用医学影像杂志》2020年第4期391-394,共4页Journal of Practical Medical Imaging

摘　　要：目的总结腱鞘巨细胞瘤(GCTTS)的超声表现,分析误诊病例,提高超声诊断准确性。方法回顾性分析2017年1月至2019年5月因软组织肿物或肿胀接受超声检查并诊断为腱鞘巨细胞瘤患者151例,与病理诊断结果对照,对确诊腱鞘巨细胞瘤病例及误诊病例的超声表现进行分析。结果超声检查诊断为腱鞘巨细胞瘤并经病理证实的患者127例,其中局限型111例、弥漫型16例,诊断准确率84.1%(127/151)。腱鞘巨细胞瘤超声主要表现为边界较清晰,形态较规则的低回声肿物,内部回声较均匀,关节囊可受累及,局限型腱鞘巨细胞瘤临近关节骨质表面较光滑,弥漫型临近关节骨质表面多毛糙。误诊24例,误诊率15.9%(24/151),其中腱鞘纤维瘤17例,神经鞘瘤3例,纤维瘤病2例,血管瘤2例。结论腱鞘巨细胞瘤超声表现具有一定特征性,通过分析确诊及误诊病例超声表现,探讨诊断及鉴别诊断的思路,仔细观察寻找声像图特征,紧密联系临床病史及症状,进一步提高诊断准确性。Objective To summarize the ultrasonographic features of giant cell tumors of tendon sheath(GCTTS)and analyze the misdiagnosed cases to improve the accuracy of ultrasonographic diagnosis.Methods Retrospective analysis 151 patients with giant cell tumors of tendon sheath were diagnosed by ultrasonography because of soft tissue masses or swelling from January 2017 to May 2019.The ultrasonographic features of giant cell tumor of tendon sheath and misdiagnosed cases were analyzed in comparison with pathological diagnosis.Results One hundred and twenty-seven cases of giant cell tumors of tendon sheath were diagnosed by ultrasonography and confirmed by pathology,including 111 cases of localized type and 16 cases of diffuse type.The diagnostic accuracy was 84.1%(127/151).Giant cell tumor of tendon sheath is characterized by clear boundary,regular low echo mass,homogeneous internal echo,involvement of articular capsule,smooth surface of articular bone near localized giant cell tumor of tendon sheath and rough surface of diffuse type near articular bone.Twenty-four cases were misdiagnosed,while misdiagnosis rate was 15.9%(24/151),including 17 cases of tenosynovial fibroma,3 cases of schwannoma,2 cases of fibromatosis and 2 cases of hemangioma.Conclusion Ultrasonographic features of giant cell tumors of tendon sheath have certain characteristics.By analyzing the ultrasonographic features of confirmed and misdiagnosed cases,to explore the idea of diagnosis and differential diagnosis,look for the characteristics carefully,relate the clinical history and symptoms closely,so as to further improve the diagnostic accuracy.

关 键 词：腱鞘巨细胞瘤 超声检查 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R738.5[医药卫生—诊断学]