手足腱鞘巨细胞瘤的高频超声表现

Sonographic findings of giant cell tumors of tendon sheath in digits

目的探讨腱鞘巨细胞瘤的二维灰阶及彩色多普勒超声的声像学特点。方法回顾性分析病理证实的26个腱鞘巨细胞瘤的声像学表现,包括肿瘤的位置,内部回声,大小,后方回声,边界,内部或边缘血流及临近肢体运动时肿瘤与肌腱的关系。结果 26个肿瘤中2个呈无回声,24个呈低回声。肿瘤最大径线5～29mm,肿瘤与腱鞘最大接触径线2～19mm。10个肿瘤后方回声增强,19个肿瘤可见血流信号。26个肿瘤均不随肌腱运动。结论腱鞘巨细胞瘤的典型声像学表现为与腱鞘相连的有血流的实性低回声肿块。

Objective To analyze the sonographic characteristics of giant cell tumors of the tendon sheath in digits. Methods Sonographic findings and other clinical records were retrospectively reviewed and analyzed in 26 masses with pathologically proven giant cell tumors of the tendon sheath. Each sonogram of the masses was blindly and retrospectively analyzed to characterize the echo texture, location, size, presence of posterior enhancement, margins and internal or peripheral vascularity. Dynamic study was also performed. Results Of the 26 masses, 2 were anechoic and 24 were hypoechoic. Posterior enhancement was present in 10 masses, and 19 masses showed internal or peripheral vascularity on color Doppler imaging. Bone erosions were noticed in 5 masses. 11 masses grew into joints. The length of contact with the tendon on long-axis views ranged from 2 to 19mm. All the lesions were in contact with a tendon, but did not move with the tendon when the affected digit flexed or extended. Conclusions Giant cell tumors typically appear as solid, hypoechoic masses related to the tendon sheath that is hypervascular on colour Doppler imaging. Sonography can provide exact information about a tumor and its relationship with the surrounding tissue, which indicates that it can be used as the first method to diagnose a giant cell tumor of the tendon sheath.