Imaging Findings Of Giant Cell Tumor Of Tendon Sheath

ObjectiveGiant cell tumor of tendon sheath is a rare benign soft tissue tumor. Due to the different growth characteristics, GCTTS can be divided into two categories, including localized type and diffuse-type.To explore the imaging performances of GCTTS so as to increase the understanding of the disease and to improve the accuracy of imaging diagnosis.MethodsThirty-nine cases of GCTTS confirmed by pathological examination were retrospectively analyzed. Of the 39 cases,32 were diffuse form and 7 localized form.Seventeen patients underwent X-ray examination,18 had CT pain examination,37 had pain MR imaging and 17 had contrast-enhanced MR imaging. X-ray plain film was examined by Dutch Philips DR machine. CT was examined by Germany SOMATOM Sensation 16 layers spiral CT:slice thickness 2.5 mm, layer spacing 2.5 mm. MR imaging was examined by American GE Signal 1.5 or 3.0 T MRI scanner, MRI scanning sequences including:conventional SE sequence coronal, sagittal and axial sectional scan; FSE sequence Sagittal double echo proton density weighted imaging (PDWI) scanning; Sagittal or axial fat suppression short time inversion recovery (STIR) sequence scan. MRI enhancement scan is a axial, coronal and sagittal multi-azimuth T1 WI fat suppression scan after the injection of Gd-DTPA contrast agents.ResultsX-ray showed local slightly higher density soft tissue mass,the adjacent bones were shown destruction or erosion in different degrees(10/17). No obvious calcifiaction and periosteal reaction were shown. CT scans could provide images better than X-ray films.CT showed local soft tissue mass in the periarticular muscle gap, part lobulated, obvious cross-jointed growth(8/18),and,the adjacent bones were shown destruction or erosion in different degrees (11/18).No obvious calcifiaction and periosteal reaction were shown. At MRI, the most cases were isointense on T1WI (32/37),and the most cases were hyperintense on T2WI (27/37). The signal intensities of the most cases tended to be heterogeneously enhanced following Gd-DTPA administration (14/17).The lesions were typically located in relation to a tendon or partially/completely enveloping it.ConclusionThe imaging findings of GCTTS have some certain characteristics. MRI is able to depict the characteristic internal signal of GCTTS and the relations with adjacent tissue> which is a valuable for diagnosis, treatment and follow-up. MRI has a very high sensitivity and specificity in the diagnosis of GCTTS,but sometimes it must be combined with clinical manifestation, X-ray and CT performances in differential diagnosis.