目的：探讨腕关节腱鞘巨细胞瘤的影像学表现特点，提高对该病的认识。方法：回顾性分析7例经手术病理证实的腕关节腱鞘巨细胞瘤的影像学资料。7例病例中，6例行CT检查，4例行MRI检查，1例行超声检查，2例行骨扫描。结果：6例腕关节腱鞘巨细胞瘤在CT上表现为软组织密度肿块，呈分叶状，部分跨关节生长，无钙化，邻居骨质受侵且无骨膜反应，明显不均强化；MRI上表现T1WI稍低信号， T2WI混杂信号，增强后明显不均匀强化，病变与邻近肌腱关系密切。结论：腕关节腱鞘巨细胞瘤的CT和MRI表现有一定的特征。
Abstract
Objective: To study the imaging features of giant cell tumor of tendon sheath(GCTTS) in the wrist joint to improve our level of understanding the disease. Methods: Seven surgically-and-pathologically-confirmed GCTTS cases were analyzed in the study. Six cases underwent pre-contrast and contrast enhanced CT examinations, 4 patients had MR imaging, one case underwent ultrasonography, two cases underwent bone scanning. Results: CT identified a lobulated mass lesion with destruction of adjacent bones, cross-jointed growth, without calcification and periosteal reaction; heterogeneous enhancement was found on contrast enhanced CT. MRI revealed iso-intensity on T1WI and hyper?蛐hypo-intense on T2WI, which were compared with those skeletal muscle. The masses were markedly heterogeneously enhanced following Gd-DTPA administration. All the lesions were typically related with the adjacent tendon. Conclusion: Some certain characteristics could be found on the imaging of CT and MRI of GCTTS in the wrist joint.
关键词
巨细胞瘤 /
骨 /
腕关节 /
体层摄影术 /
螺旋计算机 /
磁共振成像
Key words
Giant cell tumor of bone /
Wrist joint /
Tomography, spiral computed /
Magnetic resonance imaging
中图分类号：
Ｒ738.2
Ｒ730.262
Ｒ814.42
Ｒ445.2
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]Ho CY, Maleki Z. Giant cell tumor of tendon sheath: cytomorphologic and radiologic findings in 41 patients[J]. Diagn Cytopathol, 2012, 40(S2): E94-E98.
[2]Ozalp T, Yercan H, Kurt C, et al. Giant-cell tumors of the tendon sheath involving the hand or the wrist: an analysis of 141 patients[J]. Acta Orthop Traumatol Turc, 2004, 38(2): 120-124.
[3]李淳，韦加宁，赵俊会，等. 86例上肢腱鞘巨细胞瘤长期随访结果[J]. 中华手外科杂志，2001，17（3）：151-154.
[4]黄建军. 腱鞘巨细胞瘤的MRI表现[J]. 华西医学，2012，27（8）：1205-1208.
[5]谢安，刘建宾. 腱鞘巨细胞瘤MRI表现及信号特点[J]. 放射学实践，2012，27（9）：990-999.
[6]Monaghan H, Salter DM, Al-Nafussi A. Giant cell tumour of tendon sheath(localized nodular tenosynovitis): clinicopathological features of 71 cases[J]. J Clin Pathol, 2001, 54(5): 404-407.
[7]徐胜生，肖家和，周翔平，等. 色素沉着绒毛结节性滑膜炎、腱鞘巨细胞瘤的MRI表现及其应用价值[J]. 实用放射学杂志，2005，21（8）：850-853.
[8]Kransdorf MJ, Murphey MD. Synovial tumors[M]//Vanhoenacher FM, Van Goethem JWM. Imaging of soft tissue tumors. Philadelphia: Lippincott Williams & Wilkins, 2006: 381-436.
[9]De Schepper AM, Hogendoom PC, Bloem JL. Giant cell tumors of the tendon sheath may present radiologically asintrinsic osseouslesions[J]. Eur Radiol, 2007, 17(2): 499-502.
[10]张学勇，王明杰. 腱鞘巨细胞瘤等影像学分析[J]. 医学影像学杂志，2013，23（8）：1300-1303.
[11]Jelinek JS, Kransdorf MJ, Shmookler BM, et al. Giant cell tumor of the tendon sheath: MR findings in nine cases[J]. Am J Roentgenol, 1994, 162(4): 919-922.
[12]De Beuckeleer L, De Schepper A, De Belder F, et al. Magnetic resonance imaging of localized giant cell tumour of the tendon sheath(MRI of localized GCTTS)[J]. Eur Radiol, 1997, 7(2): 198-201.
[13]Ozalp T, Yercan H, Kurt C, et al. Giant-cell tumors of the tendon sheath involving the hand or the wrist: an analysis of 141 patients[J]. Acta Orthop Traumatol Turc, 2004, 38(2): 120-124.
[14]Kitagawa Y, Ito H, Amano Y, et al. MR imaging for preoperative diagnosis and assessment of local tumor extent on localized giant cell tumor of tendon sheath[J]. Skelet Radiol, 2003, 32(11): 633-638.
