腱鞘巨细胞瘤的影像学诊断价值

目的：探讨腱鞘巨细胞瘤的X线、CT及MRI诊断价值。方法：回顾性分析35例经手术病理证实的腱鞘巨细胞瘤病例资料。男16例，女19例；年龄7～66岁，平均39．4岁。所有病例行X线检查，8例行CT检查，16例行MR检查。结果：病变位于膝关节2例，踝关节6例，桡骨小头1例，腕关节2例，14例手部，10例足部。病变呈弥漫型10例，局灶型25例。X线：32例表现为骨旁稍高密度软组织肿块，3例正常。相应骨质受压侵蚀或小囊样破坏9例，明显骨质破坏5例。CT：能清晰显示软组织肿块及骨质破坏。MRI：在T1WI上接近于骨骼肌信号9例，稍低于骨骼肌信号7例，在T2WI上以低信号为主，混杂斑片状等高信号，6例可见少量积液改变。结论：X线可初步发现病灶及骨质破坏，CT观察骨质破坏较好，MRI特征性长T1短T2低信号，能清晰显示病灶范围及分型。

Study on the diagnostic value of imageology of giant cell tumour of tendon sheath

Objective: To investigate the diagnostic value of imageology of giant cell tumour of tendon sheath(GCTTS) including X-ray,CT and MRI. Methods: Thirty-five patients with GCTTS confirmed by operation and pathology were retrospectively analyzed. There were 16 males and 19 females. The average age was 39.4 years,ranged from 7 to 66 years. All the patients underwent X-ray examination,8 patients underwent CT examination,and 16 patients underwent MRI examination. Results: There were 2 patients in knee joint,6 patients in ankle joint,1 patient in capitulum radius,2 patients in wrist joint,14 patients in hand and 10 patients in foot. Ten cases were the diffuse form,and 25 cases were the focal form. The X-ray results:the slightly high density soft tissue mass surrounding the bone were shown in 32 cases,3 cases were normal. The bone erosion were shown in 9 cases,the obvious destruction of bone were shown in 5 cases. CT results:The soft tissue mass and the destruction of bone were shown clearly. MRI results:On T1WI,the signal intensity of GCTTS almost was similar to those of skeletal muscle in 9 cases and was slightly lower than those of skeletal muscle in 7 cases. On T2WI,the signal intensity presented mainly hypointensity with patchy isointensity or hyperintensity signal. A little of fluid was shown in 6 cases. Conclusion: X-ray can demonstrate the lesion and erosion of bone, destruction of bone can clearly be shown on CT. The low intensity signal on MRI T1WI and T2WI is the characteristic appearance of GCTTS. And it can clearly show the lesion range and type of GCTTS.