腱鞘巨细胞瘤的MRI诊断价值

Diagnostic value of MRI for giant cell tumor of tendon sheath

目的分析MRI对腱鞘巨细胞瘤的诊断价值。方法回顾性分析21例经手术和病理证实的腱鞘巨细胞瘤的病例资料,其中3例为术后复发。所有病例行MR平扫,19例同时增强扫描,总结其MRI表现特点。结果21例腱鞘巨细胞瘤中,局限性17例,弥漫性4例。在T1WI上18例接近于骨骼肌信号,3例稍低于骨骼肌信号;在T2WI上7例介于骨骼肌与皮下脂肪信号之间,12例接近于骨骼肌信号,2例稍低于骨骼肌信号。19例行T1WI脂肪抑制增强扫描,17例不均匀强化,2例均匀强化。结论MRI能够反映腱鞘巨细胞瘤的内部信号特征,对指导临床治疗和随访具有重要价值。

Objective To analyze the value of MRI in the diagnosis of giant cell tumor of tendon sheath （GCTTS）. Methods The MR images of 21 GCTTS cases including 3 cases of recurrences were retrospectively evaluated. All were confirmed giant cell tumor of tendon sheath by surgery and pathology. All the patiens were examined by MRI, and 19 received contrast enhanced MRI. The characteristics of MRI presentations were explored. Results Of the 21 cases, 17 were in diffuse form and 4 in localized form. On T1WI, the signal intensities of the giant cell tumor of tendon sheath almost equalled to those of skeletal muscle in 18 cases and were slightly lower than those of skeletal muscle in 3 cases. On T2WI, the signal intensities tended to range between those of skeletal muscle and fat in 7 cases, almost equalled to those of skeletal muscle in 12 cases, and were slightly lower than those of skeletal muscle in 2 cases. Of the 19 cases with gadoliniumenhanced images, 17 showed inhomogeneous enhancement and 2 homogeneous enhancement,and all were observed with a fat suppression sequence on T1WI. Conclusion MRI is able to depict the characteristic internal signal of giant cell tumor of tendon sheath,which is a valuable for diagnosis, treatment and follow-up.