Magnetic resonance imaging of localized giant cell tumour of the tendon sheath (MRI of localized GCTTS)

Abstract

The objective of this study was to evaluate the appearance of localized giant cell tumour of the tendon sheath (GCTTS) on unenhanced and Gd-enhanced MR images. MR images of 13 histologically proven cases of localized GCTTS were evaluated for mean size, location, homogeneity and signal intensity (SI) on both T1- and T2-weighted images, and enhancement pattern. All lesions except 1 affected young adults. On T1- and T2-weighted images, lesions showed predominantly low SI equal to or slightly higher than skeletal muscle. On Gd-enhanced T1-weighted images, strong homogeneous enhancement was seen. These findings reflect the underlying histological composition of the lesion; haemosiderin deposition in xanthoma cells, shortening T2-relaxation time, and abundant collagenous proliferation are responsible for low SI on T1- and T2-weighted images. Strong homogeneous enhancement originates from numerous proliferative capillaries in the collagenous stroma. We conclude that these characteristic MR features, together with clinical information, are a valuable diagnostic tool in offering a correct preoperative diagnosis.

Comparison of Ultrasonography and Magnetic Resonance Imaging for Diagnosis of Soft Tissue Masses of the Hand and Wrist

“…The mass is hypointense on both sequences (Figure 4) (17). Uniform enhancement can be seen on post-contrast series ( Figure 5) (17,20).…”

“…Typically, they are hypointense on T1-weighted images and hyperintense on T2-weighted images (17,19). MRI typically shows the giant cell tumor of the tendon sheath as a well-defined mass adjacent to or enveloping a tendon (18,20). The mass is hypointense on both sequences (Figure 4) (17).…”

Giant cell tumor of the tendon sheath: Magnetic resonance imaging findings in 38 patients

“…L-GCTTS is well delineated and lobulated with an incomplete fibrous capsule; however, the tumor may exhibit variability in signal intensity on MR images. De Beuckeleer et al (4) observed that the majority of signal intensities of L-GCTTS were isointense to the signal intensities of muscle on T1WI and T2WI. Jelinek et al (16) investigated the MRI features of 9 L-GCTTS.…”

“…As magnetic resonance imaging (MRI) can be used to characterize and estimate the extent of soft tissue tumors, this imaging technique is currently the method of choice for the diagnosis of GCTTS (3). Certain studies have investigated the use of MRI for the diagnosis of L-GCTTS (3)(4)(5). However, few studies have exclusively clarified the characteristic MRI features of L-GCTTS and D-GCTTS.…”

Orthopaedic Case of the Month: A 51-year-old Man with a Painless Wrist Mass

“…The decreased signal intensity is attributable to the paramagnetic effect exerted by hemosiderin, which causes a blooming artifact on the gradient echo sequences [17,26]. GCTTS typically shows moderate to marked contrast enhancement after administration of gadolinium owing to the presence of numerous proliferative capillaries located in the collagenous stroma [5,16]. Other specific MRI features that are useful in differentiating GCTTS from malignant diagnoses, such as extraskeletal osteosarcoma Fig.…”