目的:探讨MRI对下肢软组织肿瘤及肿瘤样病变的诊断价值.方法:回顾性分析25例经病理证实的下肢软组织肿瘤及肿瘤样病变的MRI表现.结果:25例中,良性11例,其中脂肪瘤5例,骨化性肌炎1例,假性动脉瘤1例,血管瘤4例;恶性14例,其中滑膜肉瘤6例,转移瘤3例,恶性纤维组织细胞瘤1例,平滑肌肉瘤1例,纤维肉瘤1例,脂肪肉瘤2例.良性组肿块最大径平均(8.36±3.50)cm,恶性组(11.9±4.61)cm,2组差异有统计学意义(P<0.05).良性组病变内部信号T1WI、T2WI以均匀中等或中等偏高信号为主,1例伴瘤周水肿;恶性组病变内部信号T1WI、T2WI以不均匀低信号为主的混杂信号,4例伴瘤周水肿(P>0.05).良性组6例未强化,恶性组均不同程度强化;良性组5例STIR呈低信号,恶性组2例STIR呈低信号;良性组无周围组织侵犯,恶性组8例伴周围组织侵犯,以上征象2组差异均有统计学意义(均P<0.05).结论:MRI能清晰显示软组织肿瘤及肿瘤样病变的边界、范围、大小、内部成分及与周围组织的关系,对良恶性的鉴别诊断价值较高.%Objective:To investigate the value of MRI in the diagnosis of soft tissue tumors and tumor-like lesions in lower limb. Methods:25 cases with pathology proven soft tissue tumors and tumor-like lesions in lower limb were retrospectively re-viewed and analyzed of its MRI characteristics. Results:There were 14 malignant tumors including synovial sarcoma (6 cases), metastatic tumors (3 cases),malignant fibrous histiocytoma (1 case),leiomyosarcoma (1 case),fibrosarcoma (1 case) and li-posarcoma (2 cases). There were 11 benign tumors including lipoma (5 cases),myositis ossificans (1 case),pseudoaneurysm (1 case) and hemangioma (4 cases). The maximum diameter of the tumor was (8.36±3.50)cm for benign group and (11.9± 4.61)cm for malignant group with significant statistical difference (P<0.05). On non-enhanced MRI,the signal intensities in be-nign tumors mostly manifested as homogeneous iso-intensity or homogeneous iso-hyperintensity on both TIWI and T2WI,and one case with peritumoral edema. The signal intensities in malignant tumors mostly manifested as in-homogeneous low-intensity on both T1WI and T2WI,and four cases with peritumoral edema (P>0.05). In benign tumors,there were 6 cases with non-enhance-ment,5 cases with low-intensity in STIR sequence and no surrounding tissue invasion;however,in malignant tumors,all cases with different levels of enhancement,2 cases with low-intensity in STIR sequence and 8 cases with surrounding tissue invasion (P<0.05). Conclusion:MRI could clearly display the margin,the size,internal composition and the relationship with the sur-rounding. It is usefully to determine the benign and malignant.
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