滑膜肉瘤的CT和MRI表现及相关病理改变  

Synovial Sarcoma: CT and MRI Manifestations and Relevant Pathological Changes

作　　者：蔡玖明 王东[2] 陈武标[2] 景志亮[2] 

机构地区：[1]广东省湛江市徐闻县人民医院放射科(广东医学院教学医院),广东徐闻524100 [2]广东医学院附属医院放射科,广东湛江524001

出　　处：《罕少疾病杂志》2013年第2期18-21,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的探讨滑膜肉瘤(SS)的CT和MRI表现及相关的病理学改变。方法回顾性分析16例SS的CT、MRI和病理学资料。结果四肢11例,躯干2例,颈部2例,纵隔1例。CT显示肿块密度大部分与肌肉密度相似或略低于肌肉密度,多不均匀;2例肿块内出现钙化,位于肿块的周边。MR检查示肿瘤软组织成分多呈T1WI等或稍低信号为主、T2WI稍高信号为主的混杂信号;6例肿块在T2WI出现明显高信号、稍高信号和低信号的三重信号;4例T2WI脂肪抑制序列见"铺路石"征;增强扫描,10例呈不均匀明显强化,分隔不强化。光镜下见上皮样细胞和梭形细胞双相分化为SS的特征性病理表现。结论 SS的CT和MRI表现具有一定特征性,联合应用有助于提高组织病理学检查的诊断准确率。Objective To investigate the CT and MRI manifestations and relevant pathological features of synovial sarcoma （SS）. Methods CT, MRI and pathological data in 16 cases with SS were retrospectively analyzed. Results 11 cases occurred in lower or upper extremities, 2 cases in body, 2 cases in neck, 1 case in mediastinal septum. On CT imaging, the lesion appeared as a soft tissue mass similar or low to muscle density, which was heterogeneous. 4 cases were demonstrated peripheral mass calcification. The soft-tissue of tumor manifested as mixed signals mainly with equal or slightly low signals on TlWI and slightly high signal on T2WI. 6 cases presented triple signal, which represented by intermixed areas of high, slightly high, and low signal intensity on T2WI. 4 cases displayed ＂cobble＂ sign on T2WI/STIR. After Gd-DTPA injection, 10 cases presented heterogeneous enhancement, the septa were unenhanced. The concurrent epithelial and spindle cell differentiation was the characteristic pathological features of SS. Conclusion SS has some characteristic manifestations on CT and MRI, which is helpful for improving the diagnostic accuracy of histopathologic examination.

关 键 词：滑膜肉瘤 体层摄影术 X线计算机 磁共振成像 病理 

分 类 号：R730.44[医药卫生—肿瘤] R445.2[医药卫生—临床医学]