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中国癌症防治杂志

中国癌症防治杂志 ›› 2016, Vol. 8 ›› Issue (4): 235-238.doi: 10.3969/j.issn.1674-5671.2016.04.08

• 临床研究 • 上一篇    下一篇

大关节弥漫型腱鞘巨细胞瘤的影像学诊断

  

  1. 广西钦州市浦北县人民医院医学影像科；广西医科大学附属民族医院放射科
  • 出版日期:2016-08-25 发布日期:2016-09-12
  • 通讯作者: 李高忠 997676230@qq.com

Imaging-based diagnosis of diffuse giant cell of tendon sheath in large joints

  • Online:2016-08-25 Published:2016-09-12

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摘要：

目的 探讨大关节弥漫型腱鞘巨细胞瘤（diffuse giant cell tumor of tendon sheath，D-GCTTS）的影像学表现特点。 方法　回顾性分析11例经手术病理证实的D-GCTTS患者的影像学资料。所有患者均行X线及MRI检查，7例行CT检查。 结果　X线检查均表现为关节旁见密度略高于肌肉的软组织肿块影，其中7例关节面下方见骨质破坏，边界较清楚；7例行CT平扫显示软组织肿块和骨质破坏征象较X线平片清晰，呈跨关节性骨质破坏，边缘硬化，软组织肿块内未见钙化。MRI检查显示病灶范围较CT清楚，9例均表现为骨旁、关节旁软组织肿块影，呈分叶状、团状，边界清楚，信号不均匀，各序列以低信号为主；6例增强后病灶呈中等度或明显不均匀强化；骨质破坏7 例，骨质破坏区信号与软组织肿块一致；关节积液 2 例。结论　大关节弥漫型腱鞘巨细胞瘤的影像表现具有一定特征性，结合X线平片、CT表现的骨质破坏情况及MRI病灶出现特征性的双低信号，可作出明确诊断。

关键词: 软组织肿瘤, 弥漫型腱鞘巨细胞瘤, 体层摄影术, X线计算机, 磁共振成像, 诊断

Abstract:

Objective To explore imaging features of diffuse giant cell tumor of tendon sheath （D-GCTTS） in large joints. Methods Imaging data were retrospectively analyzed for 11 patients with D-GCTTS in large joints，which was confirmed based on pathology analysis of surgical samples. All patients were examined by X-ray and MRI；7 were also examined by CT. Results X-ray examination revealed a mass of slightly elevated density close to joint soft tissue and muscle；7 cases showed well-defined subarticular bone destruction. The soft tissue mass and bone destruction in 7 patients was clearer by CT than by X-ray；CT also revealed cross-articular bone destruction，edge osteosclerosis，and absence of calcification within the soft tissue mass. Lesion extent in 9 cases was clearer by MRI than by CT；MRI revealed that the soft tissue mass in 9 cases was well-defined，parosteal and para-articular，lobulated，and slug，and that it showed inhomogeneous low signal in each sequence. Lesions in 6 cases showed moderate or obvious heterogeneous enhancement，and 7 cases showed bone destruction. The signal in the bone destruction zone was consistent with the soft tissue mass. Joint effusion was detected in 2 cases. Conclusion It may be possible to reliably diagnose D-GCTTS in large joints based on the detection of bone destruction by X-ray and CT as well as double low signal by MRI.

Key words: Soft tissue neoplasm, Diffuse giant cell tumor of tendon sheath, Tomography, X-rays, Magnetic resonance imaging, Diagnosis