腱鞘巨细胞瘤的MRI影像学特征分析

Feature analysis on MRI imaging characteristics of Giant Cell Tumor of Tendon Sheath(GCTTS)

目的分析腱鞘巨细胞瘤的MRI典型影像特征,同时探讨对腱鞘巨细胞瘤的诊断价值。方法选取我院2013年3月-2017年9月我院经手术病理证实的腱鞘巨细胞瘤患者43例,患者均行MRI扫描,收集患者影像学资料及临床资料,分析腱鞘巨细胞瘤在MRI检查中的图像表现及检出情况。结果 43例腱鞘巨细胞瘤患者在MRI上均表现为边界清晰的骨旁肌腱软组织肿块或肌腱旁软组织肿块。其中局限型巨细胞瘤35例,弥漫型巨细胞瘤8例。24例患者病灶在T1WI中呈等信号,12例患者病灶呈现等低信号,7例患者病灶呈现稍低信号;14例患者病灶在T2WI中呈现混合信号,9例患者病灶呈现稍高信号,11例患者病灶呈现明显高信号,9例(20.00%)患者病灶呈现低信号。行MR增强扫描的共9例,均表现为肿块均匀或不均匀中度强化,且强化区域边缘清楚。结论 MRI能良好显示腱鞘巨细胞瘤的典型影像特征,能够为临床对疾病的诊治提供可靠依据,帮助临床医生做出正确判断以及制定治疗方案。

Objective To investigate the MRI typical imaging characteristics of Giant Cell Tumor of Tendon Sheath（GCTTS）, and its diagnostic value on GCTTS. Methods A total of 43 cases with GCTTS confirmed by operation and pathology in our hospital from May 2015 to September 2017 were all given MRI scanning, imaging data and clinical data of patients were collected, imaging characteristics and detection condition of GCTTS in MRI examination were analyzed. Results All the 43 cases of GCTTS showed well-defined parosteal tendon soft tissue mass or soft tissue mass around the tendon. And 35 cases were localized type giant cell tumor, 8 cases were diffuse type giant cell tumor. 24 cases of lesions showed iso-intense signal on T1WI, 12 cases of lesions showed hypo-intense signal, 7 cases of lesions showed slight hypo-intense signal. 14 cases of lesions showed mixed signal on T2WI, 9 cases of lesions showed slightly hyperintense signal, 11 cases of lesions showed obviously hyperintense signal, 9 cases （20.00%） of lesions showed low signal. There were 9 cases given MR enhancement scan, with homogeneous or heterogeneous density, and enhancement region with clear border. Conclusion MRI can displayed the imaging characteristics of GCTTS clearly, it can provide reliable evidence for clinical diagnosis and treatment, and can help doctors make correct judgment and therapeutic schedule.