局限型腱鞘巨细胞瘤高频超声特征与病理对照分析  

Comparative Study of High-Frequency Ultrasound Characteristics and Pathology in Localized-Type Giant Cell Tumor of the Tendon Sheath

作　　者：赵小琪 朱永涛[1] 郭玲[1] 张晨[1] 刘广会[1] 李贺霞 ZHAO Xiaoqi;ZHU Yongtao;GUO Ling;ZHANG Chen;LIU Guanghui;LI Hexia(Wangjing Hospital,China Academy of Chinese Medical Science,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院超声科,北京100102

出　　处：《中国中医骨伤科杂志》2022年第4期58-61,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

摘　　要：目的:总结局限型腱鞘巨细胞瘤的超声及病理特征,提高超声诊断准确性。方法:回顾性分析2015年3月至2021年3月经手术及病理证实为局限型腱鞘巨细胞瘤的26例患者的临床资料、超声声像图资料,并与病理结果进行对照分析。结果:高频超声诊断局限型腱鞘巨细胞瘤17例,性质待定2例,误诊7例,其中误诊为腱鞘囊肿6例,神经源性肿瘤1例。局限型腱鞘巨细胞瘤超声主要表现为腱旁或关节旁边界清晰的不均匀低回声,形态规则或不规则,血流信号以Alder 0~Ⅱ级为主。局限型腱鞘巨细胞瘤在超声回声均匀组与不均匀组、边界清晰组与不清晰组、形态规则组与不规则组间最大径线比较差异均有统计学意义(P<0.05)。病理大体标本多有完整包膜,切面实性,呈灰白色或灰黄(褐)色。镜下切片观察肿瘤主要由滑膜样单核细胞、组织细胞样单核细胞、泡沫细胞、纤维母细胞及多核巨细胞构成。结论:局限型腱鞘巨细胞瘤具有一定的声像图特点,且高频超声检查操作简便,实时无创,对临床早期诊断有重要作用。Objective:To summarize the ultrasonographic features of localized-type giant cell tumor of the tendon sheath and compare with pathology to improve the diagnostic accuracy of high-frequency ultrasound.Methods:The clinical data and ultrasonographic data of 26 cases with localized-type giant cell tumor of the tendon sheath from March 2015 to March 2021 were respectively analyzed,and compared with the pathological results.Results:17 cases of localized-type giant cell tumor of the tendon sheath were diagnosed by high frequency ultrasound;2 cases were undetermined;7 cases were misdiagnosed including 6 cases as ganglion sheath cyst and 1 case as schwannoma.The manifestations of localized-type giant cell tumor of the tendon sheath were solid masses with heterogeneous hypoecho,beside tendon or around joint with clear boundary,regular or irregular shape and blood flow sign was mainly Alder grade 0~Ⅱ.There were statistically significant differences in the maximum diameter between the ultrasound echo uniform group and the inhomogeneous group,the boundary clear group and the indistinct group and the morphology regular group and the irregular group(P<0.05).The tumor was mainly composed by large synovial mononuclear cells,small histologic cell-like monocytes,fibroblasts and osteoclast-like multinucleated giant cells.Conclusion:Localized-type giant cell tumor of the tendon sheath has certain ultrasonographic features,and high-frequency ultrasound examination is simple and non-invasive,which plays an important role in early clinical diagnosis.

关 键 词：局限型腱鞘巨细胞瘤 高频超声 诊断价值 

分 类 号：R738.1[医药卫生—肿瘤]