横纹肌肉瘤的影像学诊断  

Imaging Diagnosis of Rhabdomyosarcomas

作　　者：诸静其[1,2] 汤光宇[1] 周国兴[2] 邵泓达 张建华[2] 王中秋 

机构地区：[1]同济大学附属第十人民医院放射科,上海200072 [2]同济大学附属东方医院医学影像科,上海200120 [3]南京中医药大学附属医院(江苏省中医院)放射科,210029

出　　处：《临床放射学杂志》2014年第8期1237-1242,共6页Journal of Clinical Radiology

摘　　要：目的分析横纹肌肉瘤(RMS)的CT和MRI表现,探讨其影像学表现与病理亚型的相关性。方法结合病理结果,回顾性分析22例RMS患者的CT及MRI完整资料,观察肿瘤的位置、大小、数目、范围、CT密度、MRI信号、钙化、出血、骨质破坏、转移及强化表现等,并比较胚胎型RMS(eRMS)和非eRMS的影像学表现差异。结果22例RMS患者中,发生在头颈部占45.5%(10/22),18岁以下占54.5%(12/22),单发占95.5%(21/22),肿块>5cm占72.7%(16/22),实性占68.2%(15/22),边界清但无包膜占86.4%(19/22)。CT呈等密度占70.6%(12/17),T1WI呈等信号占75%(12/16),T2WI呈稍高信号占93.8%(15/16)。肿块均匀强化占59.1%(13/22),不均匀强化占40.9%(9/22)。骨质破坏占68.2%(15/22),淋巴结及远处转移占22.7%(5/22)。所有肿块未见出血、钙化。eRMS(15例)和非eRMS(7例,其中腺泡型5例,多形型2例)的CT与MRI表现差异无统计学意义(P>0.05)。结论 RMS可发生于全身各部位,头颈部及青少年多见,常为单发、实性较大肿块,CT和MRI能准确显示肿瘤位置、形态、范围及转移情况,但缺乏特异性;RMS以胚胎型为主,不同病理亚型之间的影像学表现差异不明显。Objective To analyze CT and MRI features of rhabdomyosarcoma （RMS） and to discuss the correlations between imaging findings and pathologic subtypes. Methods Twenty-two RMS patients who had complete CT and MRI materials were enrolled in this study. The imaging findings, including the location, size, number, extent, CT attenuation, MR signal intensity, calcification, hemorrhage, bony destruction, metastasis, contrast enhancement pattern, etc. were determined, and the findings were compared with pathological results. The differences in imaging features between embryonal RMS （eRMS） and non-eRMS （including alveolar RMS and pleomorphic RMS） were statistically analyzed. Results Of the 22 patients with MRS, the lesion was located at head and neck in I0 （45.5%）, single lesion was seen in 21 （95.5%） , lesion＇s diameter 〉5cm was found in 16 （72.7%） , solid mass was seen in 15 （68.2%） , and clear border without capsule was found in 19 （86.4%）. 54.5% of patients were below 18 years old. CT scanning showed that 70.6% of lesions （12/17） presented as iso-density mass. 75% of lesions （12/16） showed iso-intensity signal on T1WI, while 93.8% of lesions （15/16） was characterized by slight hyper-intensity signal on T2WI. Homogeneous and inhomogeneous enhancement was demonstrated in 59.1% （13/22） and 40.9% （9/22） of lesions respectively. Bony destruction was detected in 68.2% of lesions （15/22）. Lymph node metastasis and distant metastasis were found in 22.7% of patients （5/ 22 ）. No hemorrhage or calcification was seen in all lesions. No statistically significant differences in CT and MRI manifestations existed between eRMS （ n = 15 ） and non-eRMS （ n = 7, including 5 alveolar RMSs and 2 pleomorphic RMSs, P 〉 0.05）. Conclusion RMS can occur at all parts of the body. Usually, RMS is more commonly seen at head and neck region in teenagers, and in most cases the lesion presents as a single, large and solid mass. CT and MRI can precisely display the location, shape

关 键 词：横纹肌肉瘤 病理亚型 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738.7[医药卫生—肿瘤]