使用 T2 磁共振成像的信号强度对手指腱鞘纤维瘤和腱鞘巨细胞瘤进行鉴别诊断。

Differential diagnosis of fibroma of tendon sheath and giant cell tumor of tendon sheath in the finger using signal intensity on T2 magnetic resonance imaging.

机构信息

Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.

Division of Radiology and Nuclear Medicine, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.

出版信息

Acta Radiol. 2021 Dec;62(12):1632-1638. doi: 10.1177/0284185120976915. Epub 2020 Dec 7.

DOI:10.1177/0284185120976915

PMID:33287550

Abstract

BACKGROUND

The differential diagnosis of fibroma of tendon sheath (FTS) and giant cell tumor of tendon sheath (GCTTS) on the basis of clinical and radiographic characteristics remains difficult.

PURPOSE

To evaluate the quantitative measurement of signal intensity (SI) obtained by magnetic resonance imaging (MRI) for the differential diagnosis of FTS and GCTTS in just the finger.

MATERIAL AND METHODS

We retrospectively identified patients with FTS (n = 6) and GCTTS (n = 22) of the finger who were treated at our hospitals between April 2011 and August 2019. Two researchers independently reviewed the MRIs and measured the regions of interest (ROIs) in the tumor and flexor tendon from the same image. The SI ratio obtained for the tumor and tendon ROIs was measured and compared using receiver-operating characteristic curve analyses. Sensitivity and specificity analyses were performed.

RESULTS

The SI ratios (mean ± SD) of FTS and GCTTS were 1.83 ± 0.64 and 6.34 ± 3.16 for researcher 1 and 1.82 ± 0.60 and 6.10 ± 3.22 for researcher 2, respectively. The areas under the curve were 0.970 and 0.970 for researchers 1 and 2, respectively. The cut-off values of the SI ratio as determined by researchers 1 and 2 for differentiating FTS from GCTTS were 3.00 and 3.00, respectively (sensitivity = 95.5%, specificity = 100%).

CONCLUSIONS

The SI ratio is useful for differentiating FTS from GCTTS independent of a combination of tumor signal and shape.

摘要

背景

基于临床和影像学特征，腱鞘纤维瘤（FTS）和腱鞘巨细胞瘤（GCTTS）的鉴别诊断仍然具有一定难度。

目的

评估磁共振成像（MRI）信号强度（SI）的定量测量在手指中用于 FTS 和 GCTTS 鉴别诊断的价值。

材料与方法

我们回顾性地选取了 2011 年 4 月至 2019 年 8 月在我院治疗的手指 FTS（n=6）和 GCTTS（n=22）患者。两名研究者独立地对 MRI 进行了复查，并从同一张图像上测量了肿瘤和屈肌腱的感兴趣区域（ROI）。通过受试者工作特征曲线分析比较了肿瘤和肌腱 ROI 的 SI 比值。进行了敏感性和特异性分析。

结果

FTS 和 GCTTS 的 SI 比值（均值±标准差）分别为研究者 1 的 1.83±0.64 和 6.34±3.16，以及研究者 2 的 1.82±0.60 和 6.10±3.22。研究者 1 和 2 的曲线下面积分别为 0.970 和 0.970。研究者 1 和 2 确定的用于区分 FTS 和 GCTTS 的 SI 比值的临界值分别为 3.00 和 3.00（敏感性=95.5%，特异性=100%）。