摘要
目的探讨MRI对软组织肿瘤的诊断价值.方法收集2001年10月至2004年8月180例软组织病变患者的MRI资料进行回顾性分析,男78例,女102例;年龄4～70岁,平均32岁;均以疼痛、软组织肿胀伴肿块形成为主要征象.全部病例均经手术、病理证实为软组织肿瘤.采用美国Picker公司0.23 T开放式磁共振扫描装置.常用脉冲序列为快速自旋回波T1WI和T2WI及短时回复序列脂肪抑制成像.检查平面包括冠状面,矢状面,横断面.180例软组织病变中,软组织良性肿瘤153例,其中肌肉血管瘤52例,腱鞘巨细胞瘤34例,神经源性肿瘤26例,脂肪瘤23例,硬纤维瘤18例;软组织恶性肿瘤17例,其中恶性纤维组织细胞瘤7例,恶性淋巴瘤3例,脂肪肉瘤2例,软骨肉瘤、肌纤维肉瘤、黑色素瘤、面部肉瘤、平滑肌肉瘤各1例;类肿瘤病变10例,其中骨化性肌炎2例,脂肪坏死8例.良、恶性肿瘤比例为9:1.手、足部腱鞘巨细胞瘤(33/34例)、血管瘤(23/52例)较为常见;恶性纤维组织细胞瘤常累及大腿(大腿4/7例)和上臂(3/7例);发生于腹股沟的肿物多为恶性(4/5例).结果良性肿瘤直径为1～18 cm,恶性肿瘤直径为4～10 cm.肿瘤形态不规则,多呈分叶状、类圆形.病变组织T1WI多为等或等低信号,T2WI多为等高信号或以高信号为主的混杂信号.神经源性肿瘤好发于皮下脂肪或肌肉间,形成囊实性肿块.位置较深的软组织肿瘤可造成邻近骨皮质的压迫,侵蚀.180例软组织病变中,有12例邻近骨受累,28例血管神经受累.结论MRI对软组织肿物检查敏感性极高,肿瘤发生的部位及某些特征有助于诊断及鉴别诊断,而肿瘤的大小、边缘光滑程度及信号强度不足以作为定性依据.
Objective To explore the diagnostic value of MRI in tumor of soft tissue. Methods The MRI manifestations of 180 soft tissue tumors dating from October 2001 to August 2004 were retrospectively analyzed, they were all confirmed by pathology. All cases were examined with Picker 0.23 T MRI. Fast spin echo(FSE)T1 and T2-weighted sequences and short tau inversion recovery (STIR/TSHIRT) fat-suppressed sequences were commonly used. MR examinations were performed at least in two of coronal, sagittal, axial planes. Of 180 cases, there were 62 vascular tumors, 34 giant cell tumor of tendon sheath, 26 neural tumors, 23 lipomas, 18 fibrous tumors; 17 malignant tumors including 7 of malignant fibrous histiocytoma(MFH), 3 of malignant lymphomas, 2 of liposarcoma and one each of chondrosarcoma, myofibrosarcoma, melanoma, facial sarcoma and leiomyosarcaoma. 10 cases were of tumor-like lesions, including 2 of myositis ossificans, 8 of fat necrosis. GCT of tendon sheath (33/34 cases), hemangiomas (23/52 cases) were common in hands and feet. MFH often involved legs and upper arms(4/7 cases, 3/7 cases). The tumors in the groin were mainly malignant(4/5 cases). Results The ratio of benign to malignant tumors was 9∶1. Tumors showed isointensity or hypointensity in T1WI and hyperintensity or mainly hyperintensity but mixed signal in T2WI. The diameter of benign tumors was 1-18 cm, the malignant was 4-10 cm. The tumors were lobulated, oblong or irregular in shape. 12 invaded to bone, 28 involved to neurovascular system. Some body parts were easily involved because of different histologic component. Conclusion The MRI for soft tissue tumors is highly sensitive. The location and some characteristical signs are useful for diagnosis, whereas the size of the lesion, the degree of border smoothness and the signal intensity are not certain for the diagnosis.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2005年第4期227-231,共5页
Chinese Journal of Orthopaedics
