摘要
目的探讨腺泡状软组织肉瘤(ASPS)的临床表现及MRI特征。方法回顾性分析病理证实的17例ASPS患者的临床和影像学资料。临床资料主要记录患者性别、年龄、肿瘤发生部位、是否有远处转移;MRI主要观察肿瘤的大小、形态、信号、边界、肿瘤血管、肿瘤强化特点。观察肿瘤时间信号强度曲线(TIC)类型,测量病灶表观扩散系数(ADC)值,分析ADC值与肿瘤大小、远处转移的相关性。结果患者男7例,女10例;年龄14~44岁,中位年龄26岁。肿瘤部位:下肢8例,臀部4例,上臂2例,腰大肌1例,手1例,腰椎1例。11例肺转移,3例骨转移,4例淋巴结转移,1例脑转移。MRI显示肿瘤位置较深,边界较清,部分可见周围浸润,内部及周围见多发迂曲增粗"流空血管"。肿瘤最大径为22~159 mm。17例均呈T1WI稍高信号,T2WI不均匀高信号,DWI高信号,ADC图低信号。最大密度投影(MIP)显示肿瘤血供丰富,周围见多发血管丛。9例增强扫描,5例持续显著强化,4例中度强化;3例TIC呈"速升-平台型",6例为"速升-缓降型"。17例ASPS平均ADC值为(0.89±0.20)×10-3mm2/s。ADC值与肿块大小、是否远处转移均呈负相关,且具有统计学意义。病理显示肿瘤细胞排列成腺泡状,周围见血窦样结构。结论ASPS临床表现及MRI表现有一定特征性,对于临床诊断具有一定的帮助。
Objective To investigate the clinical manifestations and MRI features of alveolar soft tissue sarcoma.Methods The clinical manifestations and MRI findings of 17 cases of alveolar soft tissue sarcoma confirmed by pathology were retrospectively analyzed.The clinical manifestations were mainly to observe the gender,age,location,and distant metastasis.To observe the tumor time signal intensity curve(TIC)type,measure the apparent diffusion coefficient(ADC)value of the lesion,and analyze the correlation between ADC value,tumor size and distant metastasis.Results There were 7 males and 10 females;the age ranged from 14 to 44 years,with a median age of 26 years.Tumor sites:8 cases of lower limbs,4 cases of hips,2 cases of upper arms,1 case of psoas muscle,1 case of hands,1 case of lumbar spine.11 cases of lung metastasis,3 cases of bone metastasis,4 cases of lymph node metastasis and 1 case of brain metastasis.MRI showed that the tumor was deeply located,with clear borders,some surrounding infiltrations were seen,and multiple tortuous and engorgement"flow voids"were seen within and around the lesion.The maximum diameter of the tumor is 22-159 mm.All 17 cases showed slightly high signal on T1WI,uneven high signal on T2WI,high signal on DWI,and low signal on ADC.Maximum intensity projection(MIP)shows that the tumor has a rich blood supply and multiple vascular clusters were seen around it.In 9 cases of enhanced scanning,5 cases continued to be significantly enhanced,4 cases were moderately enhanced;3 cases of TIC had"rapidly rising-curve",and 6 cases had"rapidly rising-slowly falling".The average ADC value of 17 ASPS cases was(0.89±0.20)×10-3mm2/s.The ADC value was negatively correlated with the size of the mass and whether it had metastasized,and it was statistically significant.The pathology showed that the tumor cells were arranged in an alveolar shape with blood sinusoidal structures around.Conclusion The clinical manifestations and MRI manifestations of ASPS have certain characteristics,which are helpful for clinica
作者
孟帆
黎海亮
王立峰
韩帅
蒋辉
刘翠翠
邵楠楠
袁军辉
MENG Fan;LI Hailiang;WANG Lifeng(Department of Radiology,Cancer Hospital Affiliated to Zhengzhou University,Zhengzhou,Henan Province 450000,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第8期1608-1612,共5页
Journal of Clinical Radiology