【摘要】 目的探讨腱鞘巨细胞瘤(GCTTS)的影像学表现,提高对该病的认识。方法 30例经手术和病理证实的GCTTS患者,均行X射线检查,5例行CT平扫,13例行MR平扫,3例同时行增强扫描。结果 1X射线:26例显示近关节区稍高密度软组织肿块影,2例表现为关节周围软组织肿胀,2例正常,6例伴有压迫性骨质侵蚀、破坏。2CT:能清晰显示软组织肿块及骨质破坏。3MRI:清晰显示病灶,局限型7例,弥漫型6例;T1WI上8例与骨骼肌信号相近,2例呈稍高信号,3例呈不均匀等低信号;T2WI上7例稍高于骨骼肌信号,3例呈不均匀等高信号,3例呈不均匀等低信号;3例增强扫描呈中度到明显不均匀强化;关节积液2例;骨质受侵犯2例。结论 X射线可初步发现病灶及骨质破坏;CT对于肿块及骨质受累的显示优于X射线;MRI对GCTTS有特征性表现,并敏感显示关节内外组织结构的侵犯程度及范围,是诊断GCTTS的理想检查方法。更多还原

【Abstract】 Objective To investigate the imaging manifestations of giant cell tumor of tendon sheath( GCTTS) in order to improve the knowledge of this disease. Methods Thirty GCTTS patients confirmed by surgery and pathological examination were examined by X-ray. In addition,5 cases had plain CT,13 cases were examined by MRI and 3 received contrast enhanced MRI. Results 1On X-ray films,the slightly high density soft tissue mass surrounding the joint were shown in 26 cases,iso-density mass in 2 cases,and normal in 2 cases. The bony oppressive erosion or destruction were shown in 6 cases. 2 CT scan clearly showed the soft tissue mass and the destruction of bone. 3 On MRI,the lesions of 13 cases were clearly showed. There were 6 cases with diffuse type and 7 with focal type. On the T1 WI,the signal intensities of 8 cases were similar while 2 cases had a slightly hyper intense signal and 3 cases had a heterogeneously iso-/ hypo-intensive signal when compared to those of skeletal muscle. On the T2 WI,the signals in 7 cases was slightly hyper-intensive,3 cases heterogeneously iso-/ hyper-intense and 3 cases heterogeneously hyper / hypo-intensive when compared to those of skeletal muscle. Enhanced scans of the 3 cases showed mild to marked inhomogeneous enhancement following Gd-DTPA administration.The joint effusion was presented in 2 cases. The bone erosion was shown in 2 cases. Conclusion X-ray can primarily demonstrate the lesion and erosion of bone. CT scans can provide better images than X-ray films. Specific manifestations of GCTTS can be revealed by MRI. MRI can also show the extent and the degree of intra-and extra-articular invasion. Therefore,MRI is an ideal modality for the diagnosis of GCTTS.更多还原