【摘要】 目的 评估滑膜肉瘤的影像特征。方法 收集经病理证实的滑膜肉瘤共226例,男127例,女99例,男女之比为1.3:1;年龄2～84岁,11～50岁者占80%,平均35岁。其中临床、影像资料齐全的23例,肘关节6例,足4例,髋关节4例,膝关节3例,前臂2例,脊柱及椎旁2例,踝关节及肩关节各1例。分析其影像特点。结果 X线平片表现:软组织肿块19/23例（83%）;邻近骨质破坏9/23例（39%）;斑点状、条索状及不规则形钙化9/23例（39%）;破坏区周围斑片状硬化2例;层状骨膜反应1例;病理骨折1例;未见异常2例。CT表现:软组织肿块11/11例（100%）,邻近骨质破坏7/11例（64%）,钙化511例（45%）,硬化1例,病理骨折1例。MRI表现:软组织肿块呈类圆形或分叶结节状。T₁WI与肌肉信号相比以等信号及等低信号为主;T₂WI上以与脂肪信号相似的中等信号为主的混杂信号,中等及低信号者4/12例（33%）,高、中、低3种信号者6/12例（50%）。9/12例（75%）在肿块内见低信号分隔,6/12例（50%）在肿块周围见不完整低信号包膜,4 12例（33%）见坏死或囊变;3/12例（25%）见液-液平。3/12例（25%）有出血。MRI增强扫描3例均呈明显强化,但分隔不强化。结论 滑膜肉瘤的影像表现具有一定的特征。更多还原

【Abstract】 Objective To discuss the imaging features of synovial sarcoma.Methods 226 cases of synovial sarcoma with histiopathologically proved during 1963-2008 were collected.There were 127 men and 99 woman（man:woman,1.3:1）,the ages ranged from 2 to 84 years（80% in 11-50 years） with a mean age 35 years.Of all cases,23 cases had detailed clinical and satisfactory imaging data,the lesions located at elbow joint in 6 cases,foot in 4 cases,hip joint in 4 cases,knee in 3 cases,forearm in 2 cases,vertebra and paravertebra in 2 cases,ankle in 1 case and shoulder in 1 case.The imaging features of synovial sarcoma in these 23 cases were analysed.Results X-ray showed soft tissue masses in 19/23 cases,destruction of consecutive bones in 9/23 cases,spot trabs and irregular calcification in 9/23 cases,patching sclerosis around the bone destruction in 2/23 cases,lamellar periosteal reaction in 1/23case,pathologic fracture in 1/23 case,normal in 2 cases.CT showed soft tissue masses in 11/11（100%） cases,bone destruction in 7/11（64 %） cases,calcification in 5/11（45 %） cases,patching sclerosis in 1 case,pathologic fracture in 1 cases.MRI showed that the soft tissue masses were round-like or lobulated and nodulous,the signal intensity of the lesions was primarily similar to that of skeletal muscle on T₁WI and heterogeneous with predominantly signal intensity equal to or slightly higher than that of subcutaneous fat on T₂WI.On T₂ WI,the lesions in 4/12 cases were equal and low signal intensity,6/12 cases were equal,low and high mixed signal intensity.9/12（75%） cases had low signal intensity septa within soft masses,6/12（50%） cases had low signal intensity incomplete pseudocapsule,4/12 cases had necrosis or cystic changes,3/12 cases had fluid-fluid level and 3/12 cases had hemorrhagic foci.After injection of constrast medium,the tumor displayed obvious enhancement except the septa.Conclusion The imaging features of synovial sarcoma are of certain characteristics.更多还原