下肢滑膜肉瘤的CT及MRI诊断

CT and MRI Diagnosis of Synovial Sarcomas in Lower Extremity

目的探讨下肢滑膜肉瘤的CT及MRI影像特征，以期提高对该肿瘤的诊断水平。资料与方法对18例下肢滑膜肉瘤患者的cT和／或MRI表现进行回顾性分析，所有患者均经病理证实。结景18例下肢滑膜肉瘤中：①以青壮年为主，12—42岁12例（66．67％）：大14倒（77．78％）位于膝关节以上的髋关节周围：14例（77．78％）最大径≥大于50mm，13例（72．22％）边缘较清晰：肿瘤一般呈类圆形、椭圆形或不规则形，其中可见明显坏死或囊变、出血，密度和／或信号不均。②5例行cT检查中，2例（40．00％）可见“边缘性钙化”：15例MRI检查中，T2WI及压脂戍像（sPAIR）序列均表现为以高信号为主的混杂信号，其中9例（60．00％）表现为典型“三重信号征”，8例（53．33％）表现为多发分隔及“卵石征”。③增强后肿瘤呈不均匀中度-重度异常强化，或不规则环形及小结节样异常强化。结论下肢滑膜肉瘤具有一定临床、cT及MRI特点，术前cT尤其是MRI检查，可提高滑膜肉瘤的诊断率，有助鉴别诊断和确定治疗方案。

Objective To analysis the CT and MRI appearances of synovial sarcomas￡SS￡ in lower extremity, and improve the cognition of synovial sarcomas. Material and Methods ]The CT/MRI findings of in 18 cases with SS in Lower Extremity were retrospectively analyzed.Results Among 18 cases with SS in lower extremity ： ① 12（66.67%） found in prime of one＇s life （age 12-42）, 14（77.78%） were upper knee and around hip joints, 13（72. 22%） were well-defined,tumors were generally round, oval or lobulated in shape, and often with necrosis or cystic areas, hemorrhage ,density/signal heterogeneous.② On CT, punc- tate calcification in the periphery of the lesion were showed 2（40.00% ）; On T2WI and SPAIR of MRI, 9（60.00%） with ＂triple signal % 8（8/15, 53.33%） manifesting internal septations in the lesion.Q） After contrast￡most of the tumors showed obviously hetero- geneous enhancement, or irregularly ring-shaped enhancement. Conclusion Synovial sar- comas in lower extremity has some special clinical manifestation, CT and MRI features, CT and MRI, especially MRI￡ can improve the diagnosis of SS in lower extremity,and are helpful for the differentiation and therapeutic decision.