25例手足腱鞘巨细胞瘤MRI分析

目的]分析手足腱鞘巨细胞瘤（giant cell tumors of the tendon sheath,GCTTS）的MRI表现,以提高对其认识和诊断水平。方法]回顾性分析25例经手术病理证实的手足部GCTTS患者的MRI表现特点。结果]25例手足部GCTTS中,局限型20例,弥漫型5例,所有病例均可见软组织肿块紧贴或包绕肌腱生长,其中5例可见邻近骨质侵蚀。病灶信号与正常骨胳肌相比,T1WI上19例呈等信号,4例呈等低信号,2例呈低信号;T2WI上信号表现多样化,9例呈混杂信号,6例呈高信号,4例呈稍高信号,6例呈低信号;12例增强扫描后,9例病灶呈明显不均匀强化,3例呈明显均匀强化。结论]手足GCTTS以局限型多见,MRI上表现有特征性,MRI检查对疾病诊断、治疗方案制定等可提供可靠依据。

An Analysis of MRI Manifestations of 25 Cases with Giant Cell Tumors of Tendon Sheath in Extremities

Purpose] To analyze the MRI manifestations of giant cell tumors of tendon sheath （GCTFS） in extremities to improve the diagnostic accuracy. Methods ] MRI of 25 cases with GCTTS in extremities pathologically confirmed were reviewed retrospectively. Results] Of the 25 cases, 20 cases were localized GCTTS, 5 cases were diffused GcTrs. All the lesions showed a mass adjacent to or enveloping a tendon,with the erosion of adjacent bones in 5 cases.On T1WI,the signal intensities of GCTrS were equaled to those of skeletal muscle in 19 cases, mild hypointense in 4 cases,obervious hypointense in 2 cases. On T2WI,the signal intensities of GCTUS were inhomogeneous in 9 cases, obervious hyperintense in 6 cases, mild hyperintense in 4 cases,hypointense in 6 cases. Of the 12 cases with gadolinium-enhanced images,9 cases showed inhomogeneous enhancement,and 3 cases showed homogeneous enhancement. Conclusion ] Most cases of the GCTUS in extremities are localized GcTrs, MRI is able to depict the characteristic of GCTIS,which is valuable for diagnosis and treatment.