软组织滑膜肉瘤的CT与MRI表现  

CT and MRI features of synovial sarcoma of the soft tissue

作　　者：黄丹萍[1] 江新青[1] 吴红珍[1] 陈亮[1] 

机构地区：[1]广州医学院附属广州市第一人民医院放射科,广东广州510180

出　　处：《实用放射学杂志》2013年第1期88-91,95,共5页Journal of Practical Radiology

摘　　要：目的 探讨软组织滑膜肉瘤的CT与MRI特征，以期提高对软组织滑膜肉瘤的诊断水平。方法 收集经手术和病理证实的18例滑膜肉瘤的临床及影像学资料，分析其影像学表现，2例行X线平片检查。5例行CT检查，13例行MRI检查。结果 18例软组织滑膜肉瘤患者，12例临近关节，尤其下肢大关节，6例距离关节较远，11例位置较深，9例有“钻孔样”生长趋势，8例包绕关节或骨质生长；平片表现为椭圆形、梭形或分叶状的软组织肿块，9例位于大关节旁，3例见瘤内周围性钙化；CT平扫表现为边界不清的类似或稍低于肌肉密度影，7例为囊实性，12例肿块内见异常增生肿瘤血管或出血灶；增强扫描肿块均明显不均匀或边缘强化。MRI T1WI上肿瘤信号不均匀，等或稍高于正常肌肉组织；T2WI肿瘤信号混杂，内有出血、坏死、囊变，基本显示高、等、低三重信号，11例肿瘤内有条形低信号间隔，增强后肿瘤显著不均匀强化，内分隔及囊变无强化。结论 滑膜肉瘤CT与MRI表现具有一定特征，MRI检查对于诊断软组织滑膜肉瘤具有特别的优势，有助于滑膜肉瘤的诊断及鉴别诊断。Objective To discuss the CT and MRI features of synovial sarcoma of the soft tissue and improve the imaging diagno sis accuracy . Methods Imaging findings and clinic data of 18 cases of synovial sarcoma of the soft tissue confirmed by surgery and pathology were collected, and the imaging features were analyzed. There were 2 cases performed by X-ray films,5 cases CT scan with contrast-enhancement,13 cases MR1 with contrast-enhancement. Results There were 12 cases located near joints , especially the large joints of lower extremeties, 6 cases far away from joints, 11 cases in deep positions, 9 cases showed ＂drilling-like＂ growth trend,8 cases ＂encircling-like＂ growth trend. Plain films appeared as elliptical, spindle or lobulated soft tissue masses, 9 cases loca- ted near the large joints, and 3 cases with mottled calcification within masses. CT displayed numerous soft tissue masses with ill defined margins and similar or slightly lower density compared with muscle, 7 cases were saccular solid masses, 12 cases had abnormal growths hlood vessels or bleeding oven. The enhancement of all these cases were pronounced with inhomogeneous or edge enhance- ment. On T2 WI,tumor showed uneven signal, or a little higher signal than normal muscle tissue. On T2 WI, synovial sarcomas ap- peared as prominent heterogeneity with predominantly hyperintensity, with much higher signal in cystic areas, with hemorrhage, necrosis, basically showed hyper-, iso-, and hypointense areas relative to fat constituting a triple signal intensity within a tumor, the enhancement of synovial sarcomas was pronounced and inhomogeneous enhancement, the septa configuralions and cystic areas were seen in 11 cases, which had no enhancement after injection of Gd-DTPA. Conclusion Synovial sarcoma has some characteristic ima- ging appearances on CT and MRI, especially in MRI examination,it is helpful for the diagnosis and differential diagnosis.

关 键 词：软组织 滑膜肉瘤 磁共振成像 计算机体层成像 

分 类 号：R788.7[医药卫生—口腔医学] R814.42[医药卫生—临床医学]