滑膜肉瘤的MR诊断

MR diagnosis of synovial sarcoma

目的探讨滑膜肉瘤的MRI表现特点及其病理基础。方法回顾性分析经病理证实的12例滑膜肉瘤患者资料,分析其MRI征象并与病理结果对照。结果MRI可见11例肿块位于关节旁,1例位于关节腔内;5例肿块边界清楚,7例肿块边界不清或部分不清;T1WI与肌肉信号相比,3例表现为等信号,2例表现为稍低信号,5例表现为稍高信号,2例表现为等、高混杂信号;在T2WI,10例表现为与脂肪信号类似或稍高的中等信号为主的混杂信号,另2例表现为均匀高信号;6例肿块内可见分隔;4例见坏死,5例见出血灶;注射Gd-DTPA增强扫描,8例肿块呈明显不均匀强化,4例呈大致均匀或均匀强化。结论滑膜肉瘤的MRI影像学特点对其诊断有一定的参考价值。

Objective To discuss the MRI features of synovial sarcoma. Methods The MRI was reviewed and compared with histopathology findings in 12 patients with synovial sarcoma. Results Tumors located in the extremities close to joints in 11 patients, located in the joint in 1 patient. Five tumors showed clearly defined margin, 7 tumors showed partially ill defined margins. On T1WI, 3 tumors displayed a signal intensity similar to that of skeletal muscle, 5 tumors displayed signal hyperintensity to skeletal muscle, 2 tumors displayed signal hypointensity to muscle, 2 tumors displayed heterogeneous signal intensity. On T2WI, 10 tumors displayed signal intensity equal to or slightly higher than that of subcutaneous fat, 2 tumors displayed a homogeneous high signal intensity. The septa configurations were seen in 6 tumors. Five tumors had hemorrhagic foci and 4 had necrotic areas. After the injection of Gd-DTPA, 8 tumors displayed heterogeneous enhancement, 4 tumors displayed homogeneous enhancement. Conclusion MRI manifestations are helpful for the diagnosis of synovial sarcoma.