手足部局限型腱鞘巨细胞瘤的影像表现

Imaging features of localized tenosynovial giant cell tumor in hand and foot

目的:分析手足部局限型腱鞘巨细胞瘤(L-TGCT)的X线、CT、MRI特点。方法:回顾性分析38例经手足部术后病理诊断为L-TGCT的患者,23例行X线检查,16例行CT检查,26例行MRI检查(其中11例行增强扫描)。结果:①X线平片示12例未见明显病灶,6例仅表现为软组织肿胀,5例有骨质破坏。②CT示1例病灶内见钙化灶,余15例表现为软组织密度或略高密度;6例有骨质破坏,3例有硬化边。③MRI示26例病灶边界清晰,与肌腱关系密切。其中8例见骨质吸收或破坏。T1WI上,14例呈等信号,2例呈低信号,10例呈等低混杂信号。T2WI上,2例呈等信号,9例呈稍高或高信号,15例呈等高低混杂信号,内见斑点状、线状低信号。行增强扫描11例中,2例强化不明显,4例呈明显不均匀强化,5例呈明显均匀强化。结论:L-TGCT是一组有一定特征性影像学表现的肿瘤,X线、CT可显示骨质破坏、软组织肿块,MRI上T1WI、T2WI均呈低信号对L-TGCT诊断有提示意义。

Objective:To analyze the imaging features of localized tenosynovial giant cell tumor(L-TGCT)in the hand and foot.Methods:The imaging data of 38 patients with L-TGCT,confirmed by surgery and pathology,were retrospectively analyzed.X-ray examination was performed in 23 cases,CT in 16 cases,and MRI in 26 cases(enhanced MRI in 11 cases).Results:①X-ray:there were no observable abnormalities in 12 cases,6 cases showed only soft tissue swelling and 5 cases had bone destruction.②CT:one case showed calcifications in the lesion,15 cases showed soft tissue density or slightly high density;6 cases had bone destruction and 3 cases had sclerotic edges.③MRI:26 cases of lesions had clear borders and were located close to tendons.Bone destruction was seen in 8 cases.On T1WI,the lesions were isointense in 14 cases,hypointense in 2 cases and hypo-or isointense in 10 cases.On T2WI,the lesions were isointense in 2 cases,hyper-or slightly hyperintense in 9 cases,and isointense,hyperintense or hypointense(dot-like or linear)in 15 cases.In 11 cases with enhanced examination,2 cases had no obvious enhancement,4 cases had obvious uneven enhancement,and 5 cases had obvious uniform enhancement.Conclusions:L-TGCT is a group of tumors with certain characteristic imaging features.X-ray and CT can show bone destruction and soft tissue masses.Low signal intensity both on T1WI and T2WI suggests the diagnosis of L-TGCT.