CAJ | 학술논문

目的：探讨腱鞘巨细胞瘤（ GCTTS）的影像学表现，提高对该病的认识。方法30例经手术和病理证实的GCTTS患者，均行X射线检查，5例行CT平扫，13例行MR平扫，3例同时行增强扫描。结果①X射线：26例显示近关节区稍高密度软组织肿块影，2例表现为关节周围软组织肿胀，2例正常，6例伴有压迫性骨质侵蚀、破坏。②CT：能清晰显示软组织肿块及骨质破坏。③MRI：清晰显示病灶，局限型7例，弥漫型6例；T1 WI上8例与骨骼肌信号相近，2例呈稍高信号，3例呈不均匀等低信号；T2 WI上7例稍高于骨骼肌信号，3例呈不均匀等高信号，3例呈不均匀等低信号；3例增强扫描呈中度到明显不均匀强化；关节积液2例；骨质受侵犯2例。结论 X射线可初步发现病灶及骨质破坏；CT对于肿块及骨质受累的显示优于X射线；MRI对GCTTS有特征性表现，并敏感显示关节内外组织结构的侵犯程度及范围，是诊断GCTTS的理想检查方法。
목적：탐토건초거세포류（ GCTTS）적영상학표현，제고대해병적인식。방법30례경수술화병리증실적GCTTS환자，균행X사선검사，5례행CT평소，13례행MR평소，3례동시행증강소묘。결과①X사선：26례현시근관절구초고밀도연조직종괴영，2례표현위관절주위연조직종창，2례정상，6례반유압박성골질침식、파배。②CT：능청석현시연조직종괴급골질파배。③MRI：청석현시병조，국한형7례，미만형6례；T1 WI상8례여골격기신호상근，2례정초고신호，3례정불균균등저신호；T2 WI상7례초고우골격기신호，3례정불균균등고신호，3례정불균균등저신호；3례증강소묘정중도도명현불균균강화；관절적액2례；골질수침범2례。결론 X사선가초보발현병조급골질파배；CT대우종괴급골질수루적현시우우X사선；MRI대GCTTS유특정성표현，병민감현시관절내외조직결구적침범정도급범위，시진단GCTTS적이상검사방법。
Objective To investigate the imaging manifestations of giant cell tumor of tendon sheath( GCTTS) in order to im-prove the knowledge of this disease.Methods Thirty GCTTS patients confirmed by surgery and pathological examination were exam-ined by X-ray.In addition,5 cases had plain CT,13 cases were examined by MRI and 3 received contrast enhanced MRI.Results ①On X-ray films,the slightly high density soft tissue mass surrounding the joint were shown in 26 cases,iso-density mass in 2 cases,and normal in 2 cases.The bony oppressive erosion or destruction were shown in 6 cases.②CT scan clearly showed the soft tissue mass and the destruction of bone.③On MRI,the lesions of 13 cases were clearly showed.There were 6 cases with diffuse type and 7 with focal type.On the T1WI,the signal intensities of 8 cases were similar while 2 cases had a slightly hyper intense signal and 3 cases had a het-erogeneously iso-/hypo-intensive signal when compared to those of skeletal muscle.On the T2 WI,the signals in 7 cases was slightly hy-per-intensive,3 cases heterogeneously iso-/hyper-intense and 3 cases heterogeneously hyper/hypo-intensive when compared to those of skeletal muscle.Enhanced scans of the 3 cases showed mild to marked inhomogeneous enhancement following Gd-DTPA administration. The joint effusion was presented in 2 cases.The bone erosion was shown in 2 cases.Conclusion X-ray can primarily demonstrate the lesion and erosion of bone.CT scans can provide better images than X-ray films.Specific manifestations of GCTTS can be revealed by MRI.MRI can also show the extent and the degree of intra-and extra-articular invasion.Therefore,MRI is an ideal modality for the diag-nosis of GCTTS.