目的 探讨弥漫性腱鞘巨细胞瘤 的临床和影像学表现。方法 收集18例经 手术病理证实的弥漫性腱鞘巨细胞瘤患者 的临床和影像学资料，进行回顾性分析。 18例患者年龄19-52岁，平均29岁，均行 X线平片及MRI检查。结果 病变位于膝部 6例，踝部6例，足部3例，手部3例。X线 上病变均表现为局部软组织肿块，其内均 未见明显钙化灶，15例可见邻近骨质的 破坏。MRI上病变呈分叶状肿块，边缘欠 清，T1WI 呈等、低为主混杂信号，T2WI 呈等低信号为主，高信号并存，所有病例 均可见特征性的含铁血黄素沉着的低信号 区域。增强扫描病灶呈明显不均匀强化。 MRI上有12例病变累及邻近骨髓，3例造成 邻近骨皮质压迫性骨质吸收，3例邻近骨 质未见异常。结论 弥漫性腱鞘巨细胞瘤 的临床表现和影像学特点对其的临床诊断 与治疗很有价值。

Objective To analyze the clinical and imaging characteristics of diffuse-type giant cell tumor of tendon sheath (D-GCTTS). Methods Clinical and imaging data from 18 patients with pathologically confirmed D-GCTTS were retrospectively analyzed. X-ray and MRI examination were performed on all cases. The age of the patients ranged from 19 to 52 years with an average age of 29 years. Results Six tumors occurred in knee, six in ankle, three in foot and three in hand. On X-ray films, all cases showed local soft tissue mass. There was no visible calcification in the soft tissue. Invasion of adjacent bone was identified in 15 of them. On MRI, all lesions appeared as lobulated soft tissue masses with ill-defined margin. All lesions displayed isointense and hypointense signal on T1WI and heterogeneous appearance on T2WI, mainly isointense and hypointense signal mixed with hyperintense signal. Characteristic low signal intensity areas where hemosiderin was deposited in the different sequences were identified in all cases. After the injection of GdDTPA, all tumors showed heterogeneous and strong enhancement. Twelve cases showed medullary invasion of the adjacent bone, three cases showed pressure erosion of the cortex, and three showed normal of the adjacent bone. Conclusion Characteristic imaging and clinical features of D-GCTTS is very valuable for the diagnosis and treatment of this disease.