摘要
目的 探讨西藏地区四肢皮肤原发恶性黑色素瘤的MRI表现.方法 回顾性分析10例经病理证实的四肢皮肤原发恶性黑色素瘤患者的MRI图像.10例均行MRI平扫,观察肿瘤的部位、侵犯范围、内部信号特点、测量肿瘤大小.结果 3例发生于手(其中2例为手拇指远端,1例为大鱼际),6例发生于足(5例为足底,1例为足踇趾远端),1例发生于前臂.10例形成软组织肿块,7例侵犯皮下脂肪组织,3例侵犯邻近肌腱及骨质.肿块在T1WI序列呈等高混杂信号5例,等低混杂信号2例,均匀等信号1例,均匀高信号1例,高低混杂信号1例.质子密度加权成像(PDWI)序列呈均匀高信号3例;高低混杂信号4例,其中1例合并液-液平面;等高混杂信号3例.结论 以皮肤为中心向外隆起形成软组织肿块、手指或足趾远端肿块伴骨质破坏、T1WI内部高信号等特点有助于西藏地区四肢皮肤恶性黑色素瘤的MRI诊断.
Abstract
Objective To present the MRI features of cutaneous malignant melanoma(cMM)of extremities in Tibet.Methods MRI findings were retrospectively evaluated in 10 cases of cMM,a11 of which were confirmed pathologically.10 patients were examined by MRI plain scan.The location of the tumor,the invasion range,signal intensity of each lesion were observed,the size of the tumors were measured.Results 3 cases were located in the hand(2 in the tips of the thumb,1 on the thenar eminence),6 cases on the foot(5 on the planta pedis),1 case on the forearm.10 cases had soft tissue masses.Subcutaneous tissues were invaded in 7 cases,adjacent tendons and bones were invaded in 3 cases.On T1WI,5 lesions showed intermediate and high heterogeneous signal,and 2 lesions presented as intermediate and low hetero-geneous signal,1 showed intermediatesignal,1 showed hyperintense signal,1 demonstrated high and low heterogeneous signal.On PDWI,3 lesions had hyperintense signal;4 lesions were noted as high and low heterogeneous signal,one of which had fluid-fluid levels;3 were seen intermediate and high heterogeneous signal.Conclusion Cutaneous tumor,a soft tissue mass with bone destruction in the tips of the fingers or toes,and intratumoral T,hyperintensity were helpful for the diagnosis of cMM of extremities in Tibet.
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