滑膜肉瘤CT及MRI表现  

CT and MRI manifestations of synovial sarcoma

作　　者：庄雪婷 陈杰云[1] 林晓莹[1] 黄日升[1] ZHUANG Xueting;CHEN Jieyun;LIN Xiaoying;HUANG Risheng(Department of Medical Imaging,Quanzhou First Hospital Affiliated to Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院影像科,福建泉州362000

出　　处：《中国医学影像技术》2021年第3期446-449,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察滑膜肉瘤(SS)的CT及MRI表现。方法回顾性分析20例SS患者的影像学及病理学资料,11例接受CT平扫,其中8例接受增强检查;14例接受MRI平扫,其中9例接受增强检查,分析其影像学表现。结果20例SS中,12例发生于四肢,8例发生于其他部位;病灶最大径2.1~16.0 cm,其中12例>5 cm。CT平扫病灶表现为等或稍低密度,8例密度不均匀,3例密度均匀;3例出现边缘性钙化,2例邻近骨质破坏;增强后2例呈渐进性明显强化,6例为不均匀渐进性中度或明显强化。3例MR T1WI呈均匀低或稍低信号,T2WI呈均匀高或稍高信号;11例MRI信号不均匀,其中8例伴出血呈明显高信号,7例出现“三重”信号,8例瘤内见低信号分隔,6例呈“铺路石”样改变;5例病灶周围轻度水肿。增强后2例均匀明显强化、2例不均匀中度强化、5例不均匀明显强化,其中4例见“筋膜尾征”。结论SS的CT和MRI表现具有一定特征性,有助于术前诊断。Objective To observe CT and MRI manifestations of synovial sarcoma(SS).Methods Imaging and pathological data of 20 SS patients were retrospectively analyzed,including 11 underwent plain CT,8 underwent both plain and enhanced CT,14 underwent plain MRI and 9 underwent both plain and enhanced MRI,and the imaging manifestations were analyzed.Results Lesions located in extremities in 12 cases,in the other parts in 8 cases.The maximum diameter of lesions was 2.1-16.0 cm,of 12 cases were larger than 5 cm.The lesions showed equal or slightly lower density on plain CT,with uneven density in 8 cases and uniform in 3 cases.Peripheral calcifications were detected in 3 cases,while invasion of adjacent bones were observed in 2 cases.SS showed progressive and obvious enhancement in 2 cases,uneven and moderate or obvious enhancement in 6 cases.On plain MRI,SS in 3 cases present as hypointense or slight hypointense signals on T1WI and hyper-intense or slight hyper-intense signals on T2WI,while in 11 cases present as heterogeneous intense signals.Hemorrhage and obvious hyperintensity were found in 8 cases,“triple”sign in 7 cases,low signal separation in tumor in 8 cases and“cobble”changes in 6 cases,while mild edema around lesions were noticed in 5 cases.Enhanced MRI showed uniform and obvious enhancement in 2 cases,uneven moderate enhancement in 2 cases and uneven remarkable enhancement in 5 cases,lesions with“fascial tail sign”were seen in 4 cases.Conclusion CT and MRI manifestations of SS had certain characteristics,which were helpful for preoperative diagnosis of SS.

关 键 词：肉瘤 滑膜 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738.6[医药卫生—肿瘤] R445[医药卫生—临床医学]