作　　者： (贝旭雯）; (葛宇曦）; (徐雷鸣）;

机构地区： 宁波市镇海区人民医院放射科,315202

出　　处： 《中华放射学杂志》 2017年第8期602-606,共5页

摘　　要： 目的 探讨腱鞘纤维瘤和腱鞘巨细胞瘤的MRI表现,提高对两者的诊断和鉴别诊断水平.方法 回顾性分析经手术、病理证实的17例腱鞘纤维瘤和27例腱鞘巨细胞瘤的MR资料,比较两者的病灶部位、大小、形态、邻近骨质改变、信号特征和强化方式等.将MRI诊断结果和病理结果进行对照分析.两者MRI特征的比较,连续性变量符合正态分布采用独立样本t检验,分类变量采用χ2检验,以P值＜0.05为有统计学意义.结果 腱鞘纤维瘤多呈结节状或肿块状（11例）,病灶邻近骨质吸收罕见（2例）,T2WI病灶周围见低信号环（6例）,病灶内部信号混杂偏低,低信号形态为条带状或细丝状（10例）,低信号范围多数大于1/3（10例）;增强后T1WI呈不均匀强化,部分病灶周围可见环形强化（6例）.腱鞘巨细胞瘤多呈分叶状（16例）,病灶邻近骨质可见压迫吸收（9例）,T2WI病灶周围多可见低信号环（22例）,病灶内部信号混杂偏高（17例）,低信号范围多数小于1/3（18例）;增强后T1WI示不均匀强化,无周围环形强化.统计分析显示：病灶形态、邻近骨质有无压迫吸收、T2WI病灶周围有无低信号环、病灶内部低信号的形态及范围和增强后周围有无环形强化在两者间差异有统计学意义（P值均＜0.01）;发病年龄、性别及发病部位两者间差异无统计学意义（P值均＞0.05）.结论 腱鞘纤维瘤和腱鞘巨细胞瘤的MRI表现具有一定的特征性,腱鞘纤维瘤呈结节状或肿块状,T2WI内部低信号形态呈条带状、范围多大于病灶的1/3,增强后病灶周围可见环状强化;腱鞘巨细胞瘤呈分叶状,邻近骨质可见吸收,T2WI周围可见低信号,内部低信号形态呈分隔状或颗粒状,范围多小于病灶1/3. Objective To study MRI features of fibroma of tendon sheath（FTS）and giant cell tumor of tendon sheath（GCTTS）, so as to improve the diagnosis and differential diagnosis of two lesions. Methods Seventeen patients with FTS and 27 patients with GCTTS confirmed by operation and pathology were retrospectively analyzed. All patients were examined with MRI. The location, size, shape and the relationship with the surrounding tissue, the signal feature and enhancing pattern of the two groups were compared. Imaging features in the two groups were assessed and analyzed by using independent samples t test and Chi-square test. Results FTS were nodular or mass-like lesions（n=11）. Few lesions appeared adjacent bone absorption（n=2）. On T2WI, the lesions showed peripheral low signal ring（n=6）or internal mixed low-signal intensity of was striped or filamentous configurations（n=10）. The volume of low-signal intensity accounted for more than 2/3 of the total lesion＆#39;s volume（n=6）. Enhanced T1WI, tumors revealed ring enhancement（n=6）. GCTTS appeared mostly lobulated（n=16）, common with adjacent bone compressive absorption（n=9）. On T2WI, most of lesion had a peripheral low signal ring（n=22）. Tumors revealed mixed high signals intensity with granular or patchy irregular low signal intensity scattered in the mass（n=17）, the area of low signal accounts for less than 1/3 of total neoplastic volume（n=18）. On contrast T1WI, GCTTS appeared heterogenous enhancement. Statistical analysis showed that the shape of the lesion, the presence or absence of compressive bone absorption, the presence of a low signal ring around the lesion, the shape of the Low-signal in T2WI and the proportion, and the presence of circumferential enhancement（P〈0.01）, there were statistically significant differences between the two. And there was no statistically significant difference in the age, gender and location of disease（P〉0.05）. Conclusion FTS and GCTTS has a different characteristic of MRI featu

关 键 词： 纤维瘤 巨细胞瘤 磁共振成像 鉴别诊断 腱鞘