少见部位滑膜肉瘤的影像学表现  

Imaging features of rare-location synovial sarcoma

作　　者：谌丹丹[1] 江新青[1] 魏新华[1] 杨蕊梦[1] 刘国顺[1] 苑召虎 CHEN Dandan;JIANG Xinqing;WEI Xinhua;YANG Ruimeng;LIU Guoshun;YUAN Zhaohu(Department of Radiology,Guangzhou First People's Hospital,Guangzhou 510180,China;Depurtment of Blool Transfusion,Guangzhou First People's Hospital,Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院放射科,广东广州510180 [2]广州市第一人民医院输血科,广东广州510180

出　　处：《实用放射学杂志》2020年第3期436-439,共4页Journal of Practical Radiology

摘　　要：目的探讨少见部位滑膜肉瘤(SS)的CT及MRI表现特征,以提高对其认识。方法回顾性分析经病理证实的8例少见部位SS的临床及影像学资料,结合文献分析其影像学特征。结果8例SS中,位于右颈部2例,右肺2例,右后腹、盆壁3例,左肩1例,其中4(4/8)例表现为“钻孔样”生长。CT平扫:7例均表现为较大(直径>5 cm)等、低密度软组织肿块,边界清(2例)或不清(5例),含囊变、坏死7例,出血或边缘性钙化各2例。MR平扫:3例T1WI均以等、稍低信号为主,T2WI呈高、等、低混杂信号,内见出血、钙化及分隔各2例,液-液平面1例。CT/MRI增强扫描4例表现为早期、明显不均匀强化,并动脉期见增多、迂曲血管影,其中2例呈持续性强化。结论对于中青年患者发生的体积较大的软组织肿瘤,密度或信号不均匀,呈“钻孔样”生长,增强扫描明显强化,即使位于非四肢周围深部软组织,也应考虑到SS的可能。Objective To evaluate CT and MRI features of rare-location synovial sarcoma(SS),to improve its diagnostic accuracy.Methods The clinical and imaging data of 8 patients with rare-location SS confirmed by pathology were retrospectively analyzed and related literatures were reviewed.Results 2 patients had tumors located in the right neck,2 cases in the right lung,3 cases in the right-posterior abdominal/pelvic wall and 1 case in the left shoulder.4 cases of them showed"drilling-like"growth.On CT plain scan,all 7 cases with large diameters(>5 cm)appeared similar or low to muscles in density,2 cases showed clearly defined margin and 5 showed poorly defined margin.They were heterogeneous with cystic necrosis in 7 lesions,hemorrhage and marginal calcification in 2 lesions respectively.On T1WI,3 cases showed iso-signal and slightly hypo-signal intensity similar to the skeletal muscles.On T1WI,they were all mixed hyper-/iso-/hypo-signal in tensity which con tained fluid-fluid level in 1 case and hemorrhage,calcification,fibrous septa in 2 cases respectively.Contrasl-enhnnced scanning revealed rapid,obvious and heterogeneous enhancement in 4 cases,which showed in creased and tortuous vessels in arterial phase.2 cases of them displayed continuous enhancement in delayed phase.Conclusion Even it not loacted around the deep soft tissue of limbs,SS should be considered when the tumor shows large soft tissue tumors with heterogeneous density or signal,"drilling-like"growth and obvious enhancement in young and middle-aged patients.

关 键 词：滑膜肉瘤 计算机体层成像 磁共振成像 

分 类 号：R738.5[医药卫生—肿瘤] R814.42[医药卫生—临床医学]