提出一种使用磁共振成像（MRI）预测扩散型肌腱鞘滑膜细胞瘤（D-TSGCTs）的模型。先对解剖位置进行分类，然后评估MRI上的结节性、边缘、周边和内部低信号、以及骨头和软骨的受累情况。进行了学生t检验、卡方检验、诊断表现、逻辑回归分析和决策树。本研究纳入了19个关节内（11个局限性; 8个扩散性）和55个额外的（44个局限性; 11个扩散性）TSGCTs。额外的D-TSGCTs表现出更频繁的多结节（72.7% vs. 25.0%，p = 0.009）和渗出性病变（90.9% vs. 34.1%，p = 0.002），并且不具有周边低信号（90.9% vs. 18.2%，p < 0.001），其内部低信号呈颗粒状（72.7% vs. 31.8%，p = 0.003），同时更频繁的涉及骨头（81.8% vs. 27.3%，p = 0.003）和软骨（50.0% vs. 0.0%，p = 0.038），相比局限性类型。关节内D-TSGCT也在所有MRI特征上（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）表现出显著差异，仅骨受累方面（37.5% vs. 9.1%，p = 0.352）与局限性类型无异。无论位置如何，软骨受累都表现出最高的特异性（88.6%～100.0%）。在关节内和关节外的D-TSGCT中，结节性（100.0%; 比值比[OR]: 70.000）和周边低信号（90.9%; OR: 62.250）分别表现出最高的敏感性OR。MRI模型对于D-TSGCG，在两个解剖位置都以软骨受累开始，接下来在关节内和关节外位置分别在结节性和周边低信号上进行预测，分别表现出100%和90.9%的敏感性和100%和77.2%的特异性。MRI结合解剖位置和成像特征可以建议D-TSGCT风险。版权所有©2023年大学放射学协会。Elsevier Inc.发表，保留所有权利。

To propose a magnetic resonance imaging (MRI) prediction model for diffuse-type tenosynovial giant cell tumors (D-TSGCTs).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.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.MRI can suggest the risk of D-TSGCT by combining imaging features with anatomic locations.Copyright © 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.