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目的探讨腱鞘巨细胞瘤的MRI表现及临床特点。方法收集2013年3月至2015年9月河南省人民医院收治的腱鞘巨细胞瘤患者进行回顾性分析。16例患者均经手术病理证实为腱鞘巨细胞瘤,均行MRI平扫检查,3例行MRI增强扫描。结果 16例腱鞘巨细胞瘤患者中9例为局限型、6例为弥漫型。13例以手足部或大关节旁无痛性肿块就诊,3例为切除后反复发作。与骨骼肌肌腹相比,MRI平扫病灶T1WI为稍低信号、T2WI为稍高信号,病灶信号混杂,其内T1WI及T2WI双低信号为其特征性表现;增强扫描呈不均匀明显强化。结论腱鞘巨细胞瘤具有较典型MRI表现及临床特点,MRI能够准确显示病变的信号特点、病变范围及与周围组织关系,为腱鞘巨细胞瘤的临床诊治提供有力依据。
Objective To investigate the MRI findings and clinical features of giant cell tumor of tendon sheath. Methods We retrospectively analyzed the patients with giant cell tumor of tendon sheath treated in Henan Provincial People’s Hospital from March 2013 to September 2015. Twenty-six patients were proved to be giant cell tumor of tendon sheath by pathology. All patients underwent MRI plain scan and three patients underwent MRI enhanced scan. Results Of the 16 patients with giant cell tumor of tendon sheath, 9 were localized and 6 were diffuse. Thirteen cases were treated with painless mass beside the hand, foot, or joint, and three cases were recurrent after resection. Compared with the skeletal muscles, T1WI was a slightly lower signal on MRI plain lesions, slightly higher signal was on T2WI, and mixed signals of lesion were detected. The double low signals of T1WI and T2WI were the characteristic manifestations. CONCLUSION: Tenosynovical giant cell tumor has typical MRI features and clinical features. MRI can accurately display the signal characteristics, the extent of the lesion and the relationship with the surrounding tissues, and provide a powerful basis for the clinical diagnosis and treatment of giant cell tumor of the tendon.