膝关节腱鞘巨细胞瘤MRI诊断

MR imaging diagnosis of giant cell tumour of the tendon sheath in the knee

目的:探讨MRI对膝关节腱鞘巨细胞瘤的诊断及鉴别诊断价值。方法:回顾性分析经病理证实的18例膝关节腱鞘巨细胞瘤患者的影像学资料,其中行MRI平扫18例,增强扫描17例。结果:18例中肿瘤呈局限型15例,弥漫型3例。病灶主体在T1WI上接近于骨骼肌信号11例,稍低于骨骼肌信号5例,介于骨骼肌与皮下脂肪信号之间2例。在T2WI上4例信号介于骨骼肌与皮下脂肪之间,5例接近于骨骼肌信号,9例稍低于骨骼肌信号,信号不均匀。17例行增强扫描,13例呈中度或明显不均匀强化,2例中度均匀强化,2例轻度不均匀强化。14例病变边缘于T1WI及T2WI上可见完整(2例)或不完整(12例)的低信号包膜影,6例病灶内可见低信号的分隔影。结论:MRI能反映膝关节腱鞘巨细胞瘤的病理特点,对本病的诊断及鉴别诊断有重要价值。

Objection：To study the MRI diagnosis and differential diagnosis of giant cell tumor of tendon sheath of knee joint. Methods： 18 cases of the giant cell tumor of tendon sheath of knee joint confirmed by pathology were retrospec- tively analyzed. All the patients underwent MRI plain scan, 17 cases underwent plain scan and enhanced scan. Results： 15 ca- ses showed confined type and 3 diffuse type. The signal intensity was similar to a skeletal muscle in 11 cases on T1 WI,in 5 cases it was slightly lower than the skeletal muscle signal, and the signal of 2 tumors ranged from that of skeletal muscle to subcutaneous fat. On T2 WI,4 cases had the signal between that of skeletal muscle and subcutaneous fat, 5 cases had signal similar to that of muscle,and 9 cases slightly lower than the skeletal muscle signal. The signal was not uniform. In 17 cases underwent routine enhanced scan, 13 cases had moderately or markedly inhomogeneous enhancement,two cases had moder- ate and mild homogeneous enhancement. Complete or incomplete low signals of the capsules were displayed around the le- sion in 14 patients. 6 cases had tow signal septa inside： Conclusion： MRI can reflect the pathologic characteristics of giant cell tumor of tendon sheath of knee joint,and has great value in clinical diagnosis and follow-up.