弥漫性腱鞘巨细胞瘤的影像学分析

目的探讨弥漫性腱鞘巨细胞瘤的临床和影像学表现。方法收集18例经手术病理证实的弥漫性腱鞘巨细胞瘤患者的临床和影像学资料,进行回顾性分析。18例患者年龄19-52岁,平均29岁,均行X线平片及MRI检查。结果病变位于膝部6例,踝部6例,足部3例,手部3例。X线上病变均表现为局部软组织肿块,其内均未见明显钙化灶,15例可见邻近骨质的破坏。MRI上病变呈分叶状肿块,边缘欠清,T1WI呈等、低为主混杂信号,T2WI呈等低信号为主,高信号并存,所有病例均可见特征性的含铁血黄素沉着的低信号区域。增强扫描病灶呈明显不均匀强化。MRI上有12例病变累及邻近骨髓,3例造成邻近骨皮质压迫性骨质吸收,3例邻近骨质未见异常。结论弥漫性腱鞘巨细胞瘤的临床表现和影像学特点对其的临床诊断与治疗很有价值。

Imaging Diagnosis of Diffuse-type Giant Cell Tumor of Tendon Sheath

Objective To analyze the clinical and imaging characteristics of diffuse-type giant cell tumor of tendon sheath (D-GCTTS).Methods Clinical and imaging data from 18 patients with pathologically confirmed D-GCTTS were retrospectively analyzed. X-ray and MRI examination were performed on all cases. The age of the patients ranged from 19 to 52 years with an average age of 29 years.Results Six tumors occurred in knee, six in ankle, three in foot and three in hand. On X-ray films, all cases showed local soft tissue mass. There was no visible calcification in the soft tissue. Invasion of adjacent bone was identified in 15 of them. On MRI, all lesions appeared as lobulated soft tissue masses with ill-defined margin. All lesions displayed isointense and hypointense signal on T1WI and heterogeneous appearance on T2WI, mainly isointense and hypointense signal mixed with hyperintense signal. Characteristic low signal intensity areas where hemosiderin was deposited in the different sequences were identified in all cases. After the injection of Gd-DTPA, all tumors showed heterogeneous and strong enhancement. Twelve cases showed medullary invasion of the adjacent bone, three cases showed pressure erosion of the cortex, and three showed normal of the adjacent bone.Conclusion Characteristic imaging and clinical features of D-GCTTS is very valuable for the diagnosis and treatment of this disease.