摘要
目的:评价增强MRI对四肢实性软组织肿块的诊断价值。方法:回顾性分析18例经手术病理证实的四肢实性软组织肿块的增强MRI表现,并与病理学结果进行对照。按肿瘤的大小、信号特征、边界、瘤周有无水肿及其强化方式进行分类,分析病变的MRI特征。结果:18例软组织肿块包括恶性肿瘤4例(其中脂肪肉瘤2例,恶性纤维肌瘤1例,纤维肉瘤1例);良性肿瘤14例(其中血管脂肪瘤3例,血管瘤3例,神经鞘膜瘤4例,神经纤维瘤2例,其它类型2例)。MRI征象中,良性组中肿块平均直径为(4.96±2.60)cm,恶性组(8.75±3.40)cm,两组间差异存在显著性意义(P<0.05);良性组肿块内部信号T1WI、T2WI上以均匀等信号为主;恶性组T1WI、T2WI上呈不均质、等高混杂信号(P>0.05);良性组中,13例表现为均质强化,恶性组中3例表现为病变不均质强化(P<0.05);良、恶性组中各有1例,肿块边界不清,瘤周可见水肿(P>0.05)。结论:MRI能明确显示四肢实性肿块的边界、范围及其与周围组织的关系,对手术计划的制订有重要意义。肿块较大,不均质强化,更提示恶性肿块,这一结论尚需在更大样本的资料中证实。
Objective:To assess the value of contrast enhanced MRI(CE-MRI) in the differential diagnosis of benign/malignant solid soft tissue tumors of extremities.Methods:18 cases with surgery and pathology proven solid soft tissue tumors in extremities were retrospectively reviewed and correlated with pathology findings.The tumor size(the maximum diameter),characteristics of signal intensities,margin,edema and enhancement patterns of the lesions showing on MRI were analyzed.Results:There were four malignant tumors including liposarcoma(n=2),malignant fibromyoma and fibrosarcoma for 1 patients each and 14 benign tumors including angiolipoma(n=3),hemangioma(n=3),neurilemoma(n=4),neurofibroma(n=2) and miscellaneous(n=2).The maximum diameter of the tumor was(4.96±2.60)cm for benign group and(8.75±3.40)cm for malignant group with significant statistical difference(P〈0.05).On non-enhanced MRI,the signal intensities in benign tumors mostly manifested as homogeneous iso-intensity on both T1WI and T2WI whereas they were heterogeneous iso-hyper intensities in malignant group(P〉0.05).On CE-MRI,13 cases in the benign group showed homogeneous enhancement and 3 cases in the malignant group showed inhomogeneous enhancement(P〈0.05).Ill-defined margin of the tumor and edema were revealed(P〉0.05) in 1 case each in both benign and malignant tumors(P〉0.05).Conclusion:MRI could clearly display the margin,extent of the solid soft tissue tumor in extremities and its relationship with the surrounding tissues,which is important for planning further surgical treatment.The larger the size and inhomogeneous enhancement of the tumour might be the hint of malignant tumour.However,this conclusion still should be proven in further study with data of larger samples.
出处
《放射学实践》
北大核心
2011年第4期442-445,共4页
Radiologic Practice
关键词
软组织肿瘤
四肢
磁共振成像
诊断
鉴别
Soft tissue neoplasms
Extremities
Magnetic resonance imaging
Diagnosis
differential