腱鞘巨细胞瘤与色素沉着绒毛结节性滑膜炎的MRI表现

MRI features of giant cell tumor of the tendon sheath and pigmented villonodular synovitis

目的:分析腱鞘巨细胞瘤与色素沉着绒毛结节性滑膜炎的MRI表现特点。方法:回顾性分析28例(腱鞘巨细胞瘤17例、色素沉着绒毛结节性滑膜炎11例)经手术病理证实的病例资料,所有病例均行MRI检查。结果:腱鞘巨细胞瘤位于膝关节3例,踝关节6例,腕关节2例,3例手部,3例足部。病变呈弥漫型11例,局限型6例。在T1WI上呈等低信号为主,在T2WI上以低信号为主,混杂斑片状等、高信号,伴肌腱、韧带侵犯11例,骨质破坏10例,关节积液7例。色素沉着绒毛结节性滑膜炎发生在膝关节9例,髋关节1例,踝关节1例,弥漫型9例,局限型2例。增生的滑膜在T1WI上呈中等或稍低信号,在T2WI上呈中等稍高信号,其内可见多发散在结节,呈T1WI、T2WI低信号灶,伴肌腱、韧带侵犯8例,骨质破坏6例,关节积液9例。结论:腱鞘巨细胞瘤与色素沉着绒毛结节性滑膜炎好发部位不同,但病灶具有相同的信号特征。

Objective：To study MRI features of giant cell tumor of tendon sheath （GCTTS） and pigmented villonodular synovitis （PVNS）. Methods：28 cases （17 eases of GCTTS, 11 eases of PVNS）confirmed by operation and pathology were retrospectively analyzed. All eases were examined by MRI. Results： Among 17 eases of GCTTS, 3 cases were located in knee joint, 6 in ankle joint, 2 in wrist joint, 3 in hand and 3 in foot. 11 eases were the diffuse form, 6 were focal. On T1WI, the signal intensity of CCTTS presented mainly isointensity or slighdy hypointensity. On T2WI, the signal intensity presented mainly hypointensity with patchy isointensity or hyperintensity signal. The violations of tendon and ligament were showed in 11 eases, destruction of bone in 10 eases, joint effusion in 7 eases. Among 11 eases of PVNS, 9 cases were located in knee joint, 1 in shoulder joint, 1 in ankle joint. 9 cases were the diffuse form, 2 were focal. On T1WI, the proliferation of synovial presented isointensity or hypointensity. On T2WI, it presented isointensity or slightly hyperintensity signal. Conclusion： GCTTS and PVNS were different in the usnal parts, but they have the same signal eharaeteristies.