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目的探讨软组织滑膜肉瘤的CT和MRI影像特征,提高对该病的诊断水平。方法回顾性分析经病理证实的43例滑膜肉瘤患者的CT和MRI资料,根据肿瘤的大小、边界、密度、信号特点和强化方式,分析其影像征象。结果 43例患者中,肿瘤位于下肢关节附近、骨旁或肌肉间隙共23例,约占53.5%,上肢关节附近6例,椎体5例,颈部3例,鼻咽腔3例,纵隔2例,前列腺1例。肿瘤最小径1.7 cm,最大径12.8 cm,,平均约4.7 cm。CT平扫肿瘤多表现为边界较为清晰的圆形、类圆形、梭形或结节状软组织肿块,可有分叶,密度与肌肉组织相仿,可见坏死、囊变,7例肿瘤内见钙化。MRI平扫T_1WI像上表现为等、稍高、稍低或混杂信号,T_2WI像上,25例表现为稍高信号或混杂高信号,内含出血、坏死、囊变区。增强扫描表现为明显不均匀强化,其中2例可见异常粗大的血管影。结论滑膜肉瘤CT和MRI特征多变,其影像学特点对其诊断有一定的价值,确诊仍需要结合病理检查。
Objective To investigate the CT and MRI features of soft tissue synovial sarcoma and to improve the diagnosis of the disease. Methods The CT and MRI data of 43 patients with synovial sarcoma confirmed by pathology were retrospectively analyzed. The image signs were analyzed according to tumor size, border, density, signal characteristics and intensifying methods. Results Among the 43 patients, the tumors were located in the joints of the lower extremity. There were 23 cases (53.5%) in the periosteal or intramuscular space, 6 cases in the upper extremity, 5 cases in the vertebral body, 3 cases in the neck, 3 cases in the nasopharynx and 3 cases in the mediastinum Cases, 1 case of prostate. The smallest diameter of tumor 1.7 cm, maximum diameter of 12.8 cm ,, an average of about 4.7 cm. CT scan of the tumor showed more clear boundaries of round, round, fusiform or nodular soft tissue mass, can be lobulated, the density and muscle tissue similar to necrosis, cystic change seen in 7 cases of tumor calcification . MRI plain T_1WI images showed equal, slightly higher, slightly lower or mixed signals, T_2WI images, 25 cases showed slightly higher signal or mixed high signal, containing hemorrhage, necrosis, cystic area. Enhanced scanning showed markedly uneven enhancement, of which 2 cases showed abnormal thick vascular shadow. Conclusions CT and MRI features of synovial sarcoma are variable, and its imaging features have some value in the diagnosis. The diagnosis still needs to be combined with pathological examination.