儿童滑膜肉瘤CT、MRI表现

CT and MRI features in synovial sarcoma of children

目的分析儿童滑膜肉瘤(synovial sarcoma,SS)的CT和MRI表现,探讨CT和MRI对滑膜肉瘤的诊断价值。方法回顾性分析7例经手术病理证实的滑膜肉瘤患者的临床和影像学资料。结果7例SS发生于四肢及躯干深部软组织内,呈圆形或卵圆形,边界清晰,瘤体较大,6例病灶最大直径为3.4~17.8 cm,平均8.2 cm,仅1例病灶最大径小于2 cm。CT平扫呈等或稍低密度的软组织肿块,6例病灶内可见坏死区,3例病灶边缘合并有钙化。MRI平扫肿瘤实性部分T1WI呈等或稍低信号,T2WI病灶呈稍高或高信号,部分病灶内部可见分隔样低信号。CT增强和MRI增强表现相仿,多呈明显不均匀强化。结论SS影像学表现具有一定特征性,CT和MRI综合评价有助于提高滑膜肉瘤的诊断,确诊仍需依靠病理学检查。

Objective To analyze and evaluate the CT and MRI features of synovial sarcoma(SS).Methods We analyzed the clinical and imaging data of 7 cases with SS confirmed by pathology.Results 7 cases of SS happened in the limbs and trunk of deep soft tissue.The lesions were round or ovoid,that boundary was clear together with large volume.The maximum diameter was 3.4~17.8 cm of 6 lesions,with an average of 8.2 cm.For only one case of lesions,the maximum diameter was less than 2 cm.CT scan was or slightly lower density mass lesion,such as focal area of necrosis in 6 cases,3 cases of lesion edge with calcification.MRI scan showed solid tumor component T1WI,or slightly low signal,T2WI lesions showed slightly higher or high signal,part of the lesion within the visible space with low signal.CT enhanced and MRI enhanced performance was similar,more uneven was obviously improved.Conclusion Synovial sarcomas has particular characteristic imaging findings,comprehensive evaluation of CT and MRI is helpful to improve the diagnostic accuracy of synovial sarcoma.Final diagnosis still needs to rely on pathologic diagnosis.