發(fā)布時(shí)間：2018-05-08 22:42

  本文選題：腱鞘巨細(xì)胞瘤 + 色素沉著絨毛結(jié)節(jié)性滑膜炎��； 參考：《臨床放射學(xué)雜志》2015年10期

【摘要】：目的探討大關(guān)節(jié)腱鞘巨細(xì)胞瘤與色素沉著絨毛結(jié)節(jié)性滑膜炎的MRI鑒別診斷特征。方法回顧性分析經(jīng)手術(shù)病理證實(shí)的17例腱鞘巨細(xì)胞瘤和21例色素沉著絨毛結(jié)節(jié)性滑膜炎患者的MRI資料,所有病例均經(jīng)MRI檢查,其中9例腱鞘巨細(xì)胞瘤(5例行動(dòng)態(tài)增強(qiáng)掃描)和13例色素沉著絨毛結(jié)節(jié)性滑膜炎患者行增強(qiáng)掃描,采用χ2檢驗(yàn)比較兩者M(jìn)RI特征的差異。結(jié)果腱鞘巨細(xì)胞瘤在T1WI上均以等信號(hào)為主,T2WI上主要以稍高或高信號(hào)為主(11例),增強(qiáng)掃描均呈中等或明顯的欠均勻強(qiáng)化;色素沉著絨毛結(jié)節(jié)性滑膜炎在T1WI上主要呈中等或低信號(hào)(20例),T2WI上主要呈稍低信號(hào)(16例),9例病灶呈雙低信號(hào),增強(qiáng)掃描主要以中等不均勻強(qiáng)化為主(8例),兩種疾病的T1WI、T2WI信號(hào)和強(qiáng)化程度差異均有統(tǒng)計(jì)學(xué)意義(χ2值分別為10.986、10.264、6.418;P值0.01、0.01、0.05)。腱鞘巨細(xì)胞瘤與色素沉著絨毛結(jié)節(jié)性滑膜炎均以累及關(guān)節(jié)內(nèi)外為主,均可呈彌漫型或局限型,破壞骨與軟骨,導(dǎo)致關(guān)節(jié)間隙狹窄和關(guān)節(jié)積液,累及肌腱、韌帶,兩種疾病上述征象差異均無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論腱鞘巨細(xì)胞瘤與色素沉著絨毛結(jié)節(jié)性滑膜炎的MRI表現(xiàn)具有一定的特征性,T1WI、T2WI信號(hào)特點(diǎn)和強(qiáng)化程度有助于兩者鑒別診斷。
[Abstract]:Objective to investigate the MRI differential diagnosis between giant cell tumor of tendon sheath and pigmented villonodular synovitis. Methods the MRI data of 17 cases of giant cell tumor of tendon sheath and 21 cases of pigmented villonodular synovitis confirmed by surgery and pathology were analyzed retrospectively. All cases were examined by MRI. Among them 9 cases of giant cell tumor of tendon sheath were examined by dynamic contrast enhanced scanning and 13 cases of pigmented villonodular synovitis. The difference of MRI features between them was compared by 蠂 2 test. Results on T1WI, 11 cases of Giant cell tumor of tendon sheath were mainly of high or high signal intensity on T _ 2WI, and all of them showed moderate or obvious inhomogeneous enhancement on contrast enhancement. Pigmented villonodular synovitis showed moderate or low signal intensity on T1WI in 20 cases. The enhancement scan was mainly of moderate inhomogeneous enhancement in 8 cases. There were significant differences in signal intensity and enhancement degree between T1WI and T2WI between the two diseases (蠂 ~ 2 = 10.986 ~ 10.264 ~ 6.418 ~ (-1) P = 0.01 0. 01 ~ 0. 05 ~ 0. 05). Giant cell tumor of tendon sheath and pigmented villonodular synovitis mainly involve both inside and outside the joint. They can be diffuse or localized type, destroying bone and cartilage, leading to joint space stenosis and joint effusion, involving tendons and ligaments. There was no significant difference in the above signs between the two diseases. Conclusion the MRI features of giant cell tumor of tendon sheath and pigmented villonodular synovitis have some characteristics of T1WII-T2WI signal and enhanced degree, which is helpful to the differential diagnosis of the two types of synovitis.
【作者單位】： 皖南醫(yī)學(xué)院附屬弋磯山醫(yī)院影像中心;
【分類(lèi)號(hào)】：R445.2;R686

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