Thammaroj Punthip, Chowchuen Prathana, Sumananont Chat, Nasang Thitima
J Med Assoc Thai. 2016 Jul;99(7):816-22.
To describe and determine different magnetic resonance imaging (MRI) findings of giant cell tumor of tendon sheath (GCTTS) and other benign soft tissue tumors in hand..
Between January 2008 and October 2014, 21 patients’ data and MRI findings were retrospectively reviewed by two musculoskeletal radiologists; data including sex, age, location of mass, number of lesion, size, shape, fatty component, adhesion to the tendon, signal intensity, neurovascular, and osseous involvement was recorded. The present study was approved by the Ethics Committee for Human Research of Khon Kaen University.
The intra-observer and inter-observer reliability of MRI interpretation gave good agreements between two radiologists. Six patients had proven GCTTS and 15 patients had other benign soft tissue tumors, including four cases of hemangioma, four cases of lipoma, two cases each of fibroma and nodular fasciitis, and one case each of neulilemmoma, glomus tumor, and soft tissue chondroma. All GCTTS were solitary lesion with the diameter ranging from 1.2 to 6.4 cm, had well-circumscribed border and lobulation. All GCTTS were located at the volar aspect, attached to the flexor digitorum tendon. In MRI, they appeared as isointensity on T1-weighted images and hyperintensity on T2-weighted images with uniform or non-uniform enhancement. Osseous involvement was seen in all GCTTS cases. All other benign non-GCTTS showed variable MR characteristics. Two significant MRI findings on GCTTS were the presence of homogenous enhancement (p<0.01) and osseous involvement (p<0.04).
Benign soft tissue tumors in hand gave variable and overlapping MRI features. Two major MRI findings of GCTTS are the presence of uniform enhancement and/or osseous involvement. These two MRI features may be helpful for differential diagnosis of GCTTS among well-circumscribed lobulated soft tissue mass arising from the tendon of the hands.
描述并确定腱鞘巨细胞瘤（GCTTS）及手部其他良性软组织肿瘤的不同磁共振成像（MRI）表现。
回顾性分析2008年1月至2014年10月期间21例患者的数据及MRI表现，由两名肌肉骨骼放射科医生进行回顾性分析；记录的数据包括性别、年龄、肿块位置、病变数量、大小、形状、脂肪成分、与肌腱的粘连情况、信号强度、神经血管及骨质受累情况。本研究经孔敬大学人体研究伦理委员会批准。
MRI解读的观察者内及观察者间可靠性在两名放射科医生之间具有良好的一致性。6例患者确诊为GCTTS，15例患者患有其他良性软组织肿瘤，包括4例血管瘤、4例脂肪瘤、2例纤维瘤和2例结节性筋膜炎，以及1例神经鞘瘤、1例血管球瘤和1例软组织软骨瘤。所有GCTTS均为单发病变，直径范围为1.2至6.4厘米，边界清晰，有分叶。所有GCTTS均位于掌侧，附着于指屈肌腱。在MRI上，它们在T1加权图像上呈等信号，在T2加权图像上呈高信号，增强均匀或不均匀。所有GCTTS病例均可见骨质受累。所有其他良性非GCTTS均表现出不同的MR特征。GCTTS的两个重要MRI表现为均匀强化（p<0.01）和骨质受累（p<0.04）。
手部良性软组织肿瘤的MRI特征多变且有重叠。GCTTS的两个主要MRI表现为均匀强化和/或骨质受累。这两个MRI特征可能有助于在手部肌腱来源的边界清晰、有分叶的软组织肿块中鉴别GCTTS。
