滑膜肉瘤X线、CT及MRI表现

Synovial sarcoma:X-ray,CT and MRI findings

目的:分析滑膜肉瘤的X线、CT和MRI表现,旨在提高对本病的认识及早期诊断水平。方法:回顾性分析17例经病理证实的滑膜肉瘤X线平片、CT、MRI表现。结果:13例位于四肢、3例位于躯干、1例位于左肺上叶;X线、CT显示肿块密度低于肌肉,密度多不均匀,其中4例肿块内出现骨化或钙化,3例出现相邻骨骨质破坏,4例邻近骨受压骨吸收。3例肿块MRI表现为卵圆状、分叶状团块,边界清晰,信号均一,T1WI与肌肉信号相同,T2WI呈明显高信号;8例肿块在T1WI为"三重信号",T2WI压脂像见"铺路石"征;T1序列增强扫描,5例均表现为肿块内絮片状明显不均匀强化,间隔明显强化。结论:①滑膜肉瘤影像学具有一定的特征。②对于滑膜肉瘤,X线、CT联合MRI可更全面显示其影像学特征,有利于肿瘤定性和鉴别。

Objective： To study the X-ray,CT and MRI features of synovial sarcoma and improve the understanding of synovial sarcoma imaging features.Methods： The X-ray,CT and MRI findings were retrospectively reviewed in 17 patients with synovial sarcoma proved by operation and pathology.Results： 13 cases occurred in lower or upper extremities,3 cases in body,1 case in left lung.On X and CT imaging,the density of lesion was heterogeneous,with 4 cases demonstrating peripheral mass calcification,3 cases showing bone destruction,and 4 cases showing bone resorption.On T1WI,three cases were usually homogeneous with signal intensity similar to or slightly higher than that of muscles and on T2WI they presented prominent homogeneous with high signal intensity.On T1WI and T2WI/STIR,8 cases presented slightly hyperintense ＂cobble＂ nodules,with hypointense septa among the nodules.After contrast,the nodules were unenhanced or enhanced slightly,and the septa were markedly enhanced.Conclusion： Synovial sarcoma have some characteristic findings.The characteristics of synovial sarcoma can be better displayed by combing the X-ray,CT and MRI,and the qualitative and differential diagnosis can thus be improved.