MRI对软组织肿瘤的鉴别诊断价值

发布时间：2018-04-08 10:20

本文选题：软组织肿瘤　切入点：磁共振成像　出处：《放射学实践》2015年03期

【摘要】：目的:探讨软组织肿瘤的MRI表现及其组间鉴别诊断。方法:回顾性分析本院经手术病理证实的50例软组织肿瘤的病例资料,其中外周神经鞘瘤13例,侵蚀性纤维瘤10例,纤维肉瘤14例,恶性纤维组织细胞瘤7例,腺泡状软组织肉瘤6例。所有患者均行MR平扫,18例行MR增强扫描,其中2例行MR血管成像,2例行MR波谱成像。结果:50例软组织肿瘤中45例发生于四肢。纤维肉瘤与侵蚀性纤维瘤长径最长,约112.73mm与112.98mm,外周神经鞘瘤长径最短,约37.75mm。50例肿瘤边界均较清楚,T1WI呈等信号或稍高信号,T2WI呈高信号夹杂多发线样或片状低信号分隔。外周神经鞘瘤为类圆形软组织肿块,MRI特异征象为"靶征"、"神经出入征"及"脂肪彗星尾征"。侵蚀性纤维瘤T2WI呈高信号且有多发粗条状低信号分隔。纤维肉瘤主要表现为多发囊变坏死、出血及邻近组织受侵犯。恶性纤维组织细胞瘤多呈边界不清的分叶状,可见囊变坏死与出血灶,T2WI背景呈高信号。腺泡状软组织肉瘤多呈类圆形,病灶内可见血液流空信号及线样低信号分隔。结论:好发于四肢的T1WI呈等信号或稍高信号的软组织肿瘤极易混淆,但各种肿瘤的MRI表现有差异,再结合各自的临床特征,鉴别五种肿瘤并不困难。
[Abstract]:Objective: to investigate the MRI findings and differential diagnosis of soft tissue tumors.Methods: the data of 50 cases of soft tissue tumors confirmed by surgery and pathology were retrospectively analyzed, including 13 cases of peripheral neurilemmoma, 10 cases of invasive fibroma, 14 cases of fibrosarcoma and 7 cases of malignant fibrous histiocytoma.Acinar soft tissue sarcoma in 6 cases.All patients underwent Mr contrast enhanced Mr imaging in 18 cases and Mr angiography in 2 cases.Results 45 of 50 cases of soft tissue tumors occurred in limbs.Fibrosarcoma and invasive fibroma had the longest long diameter, about 112.73mm and 112.98 mm, and peripheral neurilemmoma had the shortest long diameter. The margin of tumor in about 37.75mm.50 was clear that the margin of tumor was iso-signal on T _ 1WI or high signal intensity on T _ 2WI.Peripheral neurilemmoma is a round soft tissue mass with specific MRI signs such as "target sign", "nerve exit sign" and "fat comet tail sign".The T2WI of invasive fibroma showed high signal intensity and multiple coarse stripe low signal separator.Fibrosarcoma is characterized by multiple cystic necrosis, hemorrhage and invasion of adjacent tissues.Malignant fibrous histiocytomas were usually lobular with unclear boundary, and high signal intensity could be seen in the background of cystic necrosis and hemorrhage foci on T _ 2WI.Acinar soft tissue sarcoma was round in shape, and blood flow empty signal and linear hypointensity could be seen in the lesion.Conclusion: it is easy to confuse the soft tissue tumors with iso-signal or slightly hyperintense T1WI in the extremities, but the MRI manifestations of various tumors are different, and it is not difficult to distinguish the five kinds of tumors according to their clinical characteristics.
【作者单位】：华中科技大学同济医学院附属同济医院放射科;
【基金】：国家自然科学基金资助项目(81320108013;31170899;81071133)
【分类号】：R445.2;R738.6

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