滑膜肉瘤的MRI诊断分析
发表时间：2014-06-30 浏览次数：783次
殷为民，陈宏伟，姜新宇.滑膜肉瘤的MRI诊断分析[J].临床误诊误治, 2013, 26(3).60-62
肉瘤,滑膜 磁共振成像
殷为民，陈宏伟，姜新宇
(南京医科大学附属无锡市人民医院影像中心,江苏无锡,214023)
2013
60-62
知网,万方
目的 分析滑膜肉瘤(synovial sarcoma,SS)的MRI征象,提高认识,减少误诊.方法 对我院收治并经病理检查确诊的SS 6例的MRI影像资料及病理检查结果进行回顾分析.结果 本组病变位于膝关节2例,肘关节、腹股沟、小腿及腰椎各1例.MRI影像表现:1例肿块位于腰椎前方,边界不清,相应椎体骨质破坏并累及腰大肌,后腹膜淋巴结增大.5例肿块呈类圆形或椭圆形,边界清晰,其中3例软组织肿块表现为T1 WI稍高信号,T2WI混杂高信号,有散在斑点状、线条状分隔样低信号及囊状等、高、低信号,增强后肿块实质性部分明显不均匀强化,条状分隔明显强化；另2例肿块分别位于肘关节及腹股沟肌肉间隙内,体积相对较小,TIWI稍高信号,T2WI较高信号,信号均匀,瘤壁较厚.结论 SS MRI表现有一定特征性,关节周围有边界清楚的软组织肿块,T2WI以低信号分隔成多房高、等、低混杂信号,增强后肿瘤实质成分明显强化,高度提示SS,但其最终诊断仍有赖于病理形态学、免疫组织化学或SYT-SSX融合基因检查. Objective To analyze the imaging and pathological examination results features of synovial sarcoma(SS) so as to improve awareness. of 6 patients with SS confirmed by pathological examination in Methods MRI imaging data our Mere retrospectively analyzed. Results There were 2 patients with lesion located in knee joint, one in elbow joint, one hospital in fold mguen one in cnem}s and one in lumbar vertebrae. MRI imaging manifestations: ()ne tumor located in vertebra lumbalis eroded the body of vertebra, obscure boundary and encroached the greater psoas muscle with lymphadenectasis; 5 patients'tumors with round or ellipse shapes showed well-defined margins, including 3 soft tissue tumors with slightly hyperintense on'f1WI，promiscuous hyperin- tense on T2WI，dispersive mottling and line disjunctive hypointensitv and equal, high and low signals of cystic forms. The enhance- ment of synovial sarcomas was usually pronounced in inhomogeneous, and line separation was obviously strengthened; two tumors lo- Gated in interspace of elbow joint and inguen muscles showed little volumes，slightly hyperintense on T1WI, hyperintense on T2XI, symmetrical signal and thick tumors wall. Conclusion SSMRI manifestations have a certain marks. Soft tissue masses with well-de- fined，MR images may indicate that hypointensity is divided into high，equal and low signals on T2WI, intensive parenchyma com- ponent of tumors by enhancement and should be considered as SS，but final diagnosis should depended on pathomorphology, immu- nohistochemistry and SYT-SSX fused gene examinations.
