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目的:探讨下肢软组织滑膜肉瘤的CT及MRI表现,进一步提高下肢软组织滑膜肉瘤的诊断率。方法:回顾性分析13例经手术病理证实的下肢软组织滑膜肉瘤患者的临床及影像学资料。结果:本组患者中,肿瘤位于膝关节周围9例,髋关节周围2例,踝关节周围2例;肿瘤直径6.7~13.8 cm,平均(9.12±4.67)cm。9例软组织肿块边界清楚,4例软组织肿块边界欠清楚。CT特征:肿瘤呈团块状或分叶状软组织影,肿瘤密度与周围肌肉密度相似,其内可见不规则的低密度区或钙化;3例肿瘤边缘见钙化灶。增强扫描示:肿瘤呈不均匀强化,其中2例可见异常增粗的动脉血管影。MRI特征:肿瘤呈团块状或分叶状软组织影,T1WI上与周围肌肉信号相比呈等或稍高不均匀信号;T2WI表现为以高信号或稍高信号为主的混杂信号,3例肿瘤内部可见低信号分隔;MRI增强后均表现为明显的不均匀强化。结论:下肢软组织滑膜肉瘤的CT及MRI表现具有一定的特征性,使用CT及MRI对下肢软组织滑膜肉瘤进行综合评价有助于提高其诊断率,值得临床上推广应用。
Objective: To investigate CT and MRI findings of soft tissue synovial sarcoma in lower extremities and further improve the diagnostic rate of synovial sarcoma in lower extremity. Methods: A retrospective analysis of 13 cases of pathologically confirmed soft tissue synovial sarcoma in patients with clinical and imaging data. Results: In this group of patients, the tumor was located in 9 cases around the knee joint, 2 cases around the hip joint and 2 cases around the ankle joint. The diameter of the tumor ranged from 6.7 cm to 13.8 cm with an average of 9.12 ± 4.67 cm. 9 cases of soft tissue mass clear boundaries, 4 cases of soft tissue mass less clear boundary. CT features: the tumor was clumpy or lobulated soft tissue shadow, the density of the tumor is similar with the surrounding muscle density, which can be seen within the irregular low-density area or calcification; 3 cases of tumor edge calcification. Enhanced scan showed: the tumor was uneven enhancement, of which 2 cases showed abnormal thickening of the arterial blood vessels. MRI features: the tumor was clumpy or lobulated soft tissue, T1WI compared with the surrounding muscle signal was slightly higher or higher uneven signal; T2WI showed high signal or slightly higher signal-based mixed signal, 3 cases Low signal separation can be seen inside the tumor; enhanced MRI showed significant heterogeneous enhancement. Conclusion: CT and MRI findings of soft tissue synovial sarcoma of the lower extremities have certain characteristics. The comprehensive evaluation of the soft tissue synovial sarcoma of the lower extremities with CT and MRI will be helpful to improve the diagnosis rate of the synovial sarcoma. It is worth popularizing and applying in clinic.