目的:提出弥漫型腱鞘膜巨细胞瘤(D-TSGCT)的磁共振成像(MRI)预测模型。
方法:解剖位置被分类,然后结节,margin,外围和内部低信号,在MRI上评估骨和软骨受累。学生t检验,卡方检验,诊断性能,Logistic回归分析,并执行决策树。
结果:包括19个关节内(11个局部;8个弥漫性)和55个关节外(44个局部;11个弥漫性)TSGCT。关节外D-TSGCT显示出明显更频繁的多结节(72.7%vs.25.0%,p=0.009),和浸润性病变(90.9%vs.34.1%,p=0.002),无外周低张力(90.9%vs.18.2%,p<0.001),并含有颗粒状内部低张力(72.7%与31.8%;p=0.003),骨骼频率更高(81.8%与27.3%;p=0.003)和软骨(50.0%vs.0.0%;p=0.038)受累比局部型受累。关节内D-TSGCT在所有MRI特征中也显示出意义(100.0%vs.9.1%,p=0.001;100.0%vs.27.3%,p=0.007;100.0%vs.36.4%,p=0.018;100.0%vs.27.3%,p=0.007;50.0%vs.0.0%,p=0.038),除骨受累外(37.5%vs.9.1%,p=0.352)比局部型。软骨受累表现出最高的特异性(88.6-100.0%),无论地点。结节(100.0%;比值比[OR]:70.000)和外周性低张力(90.9%;OR:62.250)在关节内和关节外病例中对D-TSGCT的敏感性最高,分别。D-TSGCG的MRI模型从两个解剖位置的软骨受累开始,然后在关节内和关节外位置的结节和外周低张力。分别,关节内TSGCTs的敏感性和特异性分别为100%和90.9%,关节外TSGCTs的敏感性和特异性分别为100%和77.2%,分别。
结论:MRI可以通过结合影像学特征和解剖位置提示D-TSGCT的风险。
OBJECTIVE: To propose a magnetic resonance imaging (MRI) prediction model for diffuse-type tenosynovial giant cell tumors (D-TSGCTs).
METHODS: Anatomic locations were classified and then nodularity, margin, peripheral and internal hypointensity, and bone and cartilage involvement were evaluated on MRI. Student\'s t-test, chi-square test, diagnostic performance, logistic regression analysis, and decision tree were performed.
RESULTS: Nineteen intra-articular (11 localized; eight diffuse) and 55 extra-articular (44 localized; 11 diffuse) TSGCTs were included. Extra-articular D-TSGCTs showed significantly more frequent multinodular (72.7% vs. 25.0%, p = 0.009), and infiltrative lesions (90.9% vs. 34.1%, p = 0.002), without peripheral hypointensity (90.9% vs. 18.2%, p < 0.001), and contained granular internal hypointensity (72.7% vs. 31.8%; p = 0.003) with more frequent bone (81.8% vs. 27.3%; p = 0.003) and cartilage (50.0% vs. 0.0%; p = 0.038) involvement than localized-type. Intra-articular D-TSGCT also showed significance in all MRI features (100.0% vs. 9.1%, p = 0.001; 100.0% vs. 27.3%, p = 0.007; 100.0% vs. 36.4%, p = 0.018; 100.0% vs. 27.3%, p = 0.007; 50.0% vs. 0.0%, p = 0.038), except bone involvement (37.5% vs. 9.1%, p = 0.352) than localized-type. Cartilage involvement revealed the highest specificity (88.6-100.0%), regardless of location. Nodularity (100.0%; odds-ratio [OR]: 70.000) and peripheral hypointensity (90.9%; OR: 62.250) demonstrated the highest sensitivities ORs for D-TSGCT in intra-articular and extra-articular cases, respectively. MRI models for D-TSGCG beginning with the cartilage involvement in both anatomic locations and next on nodularity and peripheral hypointensity in intra-articular and extra-articular locations, respectively, exhibited sensitivity and specificity of 100% and 90.9% for intra-articular and 100% and 77.2% for extra-articular TSGCTs, respectively.
CONCLUSIONS: MRI can suggest the risk of D-TSGCT by combining imaging features with anatomic locations.