伴骨质改变的腱鞘巨细胞瘤的影像分析

Imaging Manifestations of Giant Cell Tumor of Tendon Sheath with Bone Invasion

目的探讨伴骨质改变的腱鞘巨细胞瘤(GCTTS)的临床及影像特点,以提高对其的认识及诊断水平。方法回顾性分析经手术病理证实的26例伴骨质改变的GCTTS患者的临床及影像学资料,23例行X线检查,17例行CT检查,21例行MRI检查,其中9例行MRI增强扫描。结果22例为弥漫型,4例为局限型;发生于手4例,足5例,腕关节2例,踝关节3例,膝关节6例,髋关节3例,肘关节1例,肩关节1例,颞骨1例;1例发生恶变,1例为骨内GCTTS。MRI表现:T1WI以等低及等信号为主,T2WI信号表现多样化,8例软组织肿块可见"双低信号"。结论伴骨质改变的GCTTS以弥漫型居多,好发于四肢关节,当MRI出现特征性的T2WI低信号时,应考虑到伴骨质改变的GCTTS。

Objective To explore the clinical and imaging manifestations of giant cell tumor of tendon sheath(GCTTS)with bone invasion and to improve the diagnosis.Methods A retrospective analysis on clinical and imaging data of 26 patients with GCTTS with bone invasion.X-ray was performed in 23 patients,CT was performed in 17 patients,Plain MR was performed in 21 patients and enhanced examination in 9 patients.Results Of all the 26 patients,22 cases were proved to be diffuse GCTTS,while the other 4 cases were localized.4 lesions were in the hand,5 in the foot,2 in the wrist joint,3 in the ankle joint,6 in the knee joint,3 in the hip joint,1 in the elbow joint,1 in the shoulder joint and 1 in the temporal bone.Among the 26 patients,one was found to be malignant and 1 patient only showed intraosseous soft tissue without extrosseous lesion.In the MRI examination,the lesions were mainly characterized by hypointensity and isointensity on T1WI.The presentation was varied on T2WI,and 9 cases showed characteristic double hypointensity on T1WI and T2WI.Conclusion Most of GCTTS with bone invasion were diffuse,and most occurred in extremities.When there were characteristic hypointensity on T2WI in the MRI examination,GCTTS with bone invasion should be considered.