滑膜肉瘤的CT及MRI表现  

CT and MR imaging features of synovial sarcoma

作　　者：黄玉芳[1] 杨伟川[2] 高文华[1] 

机构地区：[1]中国人民解放军第422医院放射科 [2]中国人民解放军95364部队医院

出　　处：《医学影像学杂志》2016年第3期518-522,共5页Journal of Medical Imaging

摘　　要：目的探讨滑膜肉瘤的CT、MRI表现特征,提高其诊断准确率。方法回顾性分析经手术病理证实的15例滑膜肉瘤的CT和MRI表现。结果位于关节周围12例,远离关节3例。其中有3例发生远处或淋巴结转移。CT表现:9例肿瘤中2例边界不清晰,周围组织明显水肿,5例病灶呈等或稍低密度,其中4例肿瘤密度不均匀,其中2例肿瘤内可见钙化。MRI表现:10例肿瘤中5例边界不清晰,瘤周水肿明显。T_1WI 4例呈等信号,2例呈等信号夹杂斑片状稍高信号影。T_2WI上6例呈高低等不均匀信号,称为"三重信号征"。5例可见稍长T_1稍短T_2纤维分隔影。增强扫描10例肿瘤呈轻度至中度强化。结论滑膜肉瘤具有一定特征的CT及MRI表现,有助于提高诊断率。Objective To explore the CT and MRI features of synovial sarcoma .Methods The present study retrospectively examined CT （ n=9） and MRI （ n=10 ） features of 15 patients with pathologically proven synovial sarcoma .Results There were 12 cases located adjacent to the joints , and 3 cases located far away from the joints .The metastases occurred in 3 cases.CT scanning：two of nine lesions were unclearly defined and the other five tumors had clear boundary .The tumor was homogeneous in 5 cases, which displayed equal or slightly low density , and heterogeneous in 4 cases.Two cases showed calcification in the tumor . Two lesions were in contact with the bone and causing osseous destruction .Slight enhancement of the tumor was seen in all cases in CT enhancement scanning .MRI：five of ten cases had unclear boundary with tumor edema .On T1 WI, 4 cases showed homoge-nous isointensity and 2 cases showed slightly high signal interspersing in the homogeneous isointensity .On T2 WI, heterogeneous signal was observed in 6 of them showed “triple sign”, which meant isointensity , hyperintensity , and hypointensity relative to fat within a single lesion .Five of them showed hypointense linear septa .Contrast-enhanced scanning revealed heterogeneous slight or moderate enhancement in the majority of the lesions , and no-enhancement area represented cystic necrosis or hemorrhage .Internal septations showed no enhancement or slightly enhancement .Conclusion Synovial sarcoma has some specific imaging fertrues , and comprehensive analysis of CT and MRI is helpful for preoperation diagnosis .

关 键 词：滑膜肉瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R445[医药卫生—临床医学]