滑膜肉瘤CT、MRI表现与鉴别诊断

摘要

目的 分析滑膜肉瘤(SS)的CT、MRI表现,以提高对本病的认识.方法 回顾性分析经手术病理证实2 5 例SS的临床、影像学资料,1 5 例行CT检查,1 1 例同时行增强检查,1 2 例行 MRI检查,8 例行增强检查.结果 2 5 例 SS中,1 8 例位于下肢、上肢2 例、胸壁 2 例,肺、纵隔及脊柱各 1 例,1 8 例较深,1 9 例呈分叶状.与肌肉相比 CT 多表现为等或稍低密度,3 例瘤周伴钙化,9 例呈渐进性强化.MRI表现 10 例T1 WI呈等或稍低信号,9 例T2 以稍长或长T2 信号为主,9 例见囊性变,其中 7 例囊变位于外周,8例病变内见短T1 信号,3 例伴"液G液平面",9 例瘤体内见分隔征;7 例T2 WI表现为"三重信号",7 例为不均匀明显强化.结论 SS多位于下肢,边界清晰、伴出血,边缘性囊性变及T2 WI"三重信号",呈渐进性强化等特点.%Objective To analyze and evaluate the CT and MRI features of synovial sarcoma (SS).Methods Clinical and imaging data of 25 cases with SS confirmed by pathology were retrospectively analyzed.1 5 cases with CT scan,including 1 1 contrastGenhanced CT scan,and 1 2 cases with MRI scan,including 8 contrastGenhanced MRI scan.Results Among 25 cases,1 8 were located in the lower extremities,2 in the upper extremities and in the chest wall respectively,1 case in the lung parenchyma,mediastinum and spine respectively.1 8 cases were deep seated,while 1 9 cases were lobulated.On CT image,most of the lesions were isodense or hypodense to muscle,while 3 cases presented peripheral calcification,and 9 cases showed progressive enhancement.On MRI,10 cases were isointense or slight hypointense on T1 WI,while 9 cases presented hyperintense or slight hyperintense on T2 WI.9 cases showed cystic change (7 of them located in the periphery),and 8 cases showed short T1 signal.3 cases demonstrated "fluidGfluid levels",and 9 cases exhibited hypointense septa.7 cases revealed "triple sign"on T2 WI and 7 cases showed obviously heterogenous enhancement.Conclusion Synovial sarcomas are mostly located in the lower extremities,with clear margins,peripheral cystic changes,intramural hemorrhage,"triple sign"on T2 WI and progressive enhancement.