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腺泡状软组织肉瘤的MRI表现及文献复习

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目的 探讨腺泡状软组织肉瘤(ASPS)的MRI表现,提高对ASPS的诊断准确性。方法 回顾性分析经手术病理证实的9例ASPS患者的临床及MRI资料,就其MRI特点进行总结分析。结果 4例位于大腿,3例位于骨盆,1例位于小腿,1例位于颏下。7例呈梭形,1例呈不规则形,1例呈类圆形。9例边界均清晰。7例ASPS出现肺转移,其中2例还伴有脑转移。T1WI上,3例呈等信号,6例呈稍高信号。T2WI上,7例呈混杂高信号,2例呈均匀高信号。扩散加权成像(DWI)上,6例呈混杂高信号,1例呈均匀高信号,1例呈等信号;表观扩散系数(ADC)值平均值为(1。14±0。10)×10-3mm2/s。6例呈不均匀明显强化,1例均匀强化;3例ASPS的小条片状脂肪抑制(FS)-T2WI高信号区呈较明显强化。9例ASPS均见"流空血管征",其中7例瘤内及瘤周均可见"流空血管",而另外2例仅瘤周可见"流空血管"。6例ASPS见囊变、坏死。3例见"假包膜"。2例见T2WI低信号分隔。结论 ASPS内T1WI高信号及T2WI上的"流空血管征"和不均匀明显强化有助于其诊断,最终确诊依赖病理。
MRI manifestations and literature review of alveolar soft part sarcoma
Objective To investigate the MRI manifestations of alveolar soft part sarcoma(ASPS)and to improve the diagnostic accuracy of ASPS.Methods The clinical and MRI data of 9 patients with ASPS confirmed by surgical pathology were analyzed ret-rospectively,and the MRI features were summarized and analyzed.Results Four cases were located in the thigh,three cases in the pelvis,one case in the calf,and one case under the chin.Seven cases were spindle shaped,one case was irregular,and one case was quasi-circular.All nine cases had clear boundaries.Seven cases of ASPS had lung metastases,and two of these also had brain metasta-ses.On T1WI,three cases showed isointense signals,and six cases showed slightly hyperintense signals.On T2WI,seven cases showed mixed hyperintense signals and two cases showed homogeneous hyperintense signals.On diffusion weighted imaging(DWI),six cases showed mixed hyperintense signals,one case showed homogeneous hyperintense signals,and one case showed isointense sig-nal;the average apparent diffusion coefficient(ADC)value was(1.14±0.10)×10-3 mm2/s.Six cases showed inhomogeneous obvious enhancement,and one case showed homogeneous enhancement;three cases showed relatively obvious enhancement in small strip-like fat suppression(FS)-T2WI hyperintense areas of ASPS.All nine cases of ASPS showed"flow void vessels sign",with seven cases showed"flow void vessels"both intratumor and peritumor,while the other two cases showed"flow void vessels"only peritumor.Six cases of ASPS showed cystic changes and necrosis.Three cases showed"pseudocapsule".Two cases showed T2WI hypointense septa-tion.Conclusion Hyperintense signals on T1WI,"flow void vessels sign"on T2WI,and inhomogeneous obvious enhancement in ASPS are helpful for diagnosis,with final confirmation relying on pathology.

alveolar soft part sarcomamagnetic resonance imagingdiffusion weighted imagingapparent diffusion coefficient

李新勃、狄聪、王飞云、王唯伟、徐子魁

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济宁医学院附属医院医学影像科,山东 济宁 272029

长江大学附属黄冈市中心医院医学影像科,湖北 黄冈 438000

腺泡状软组织肉瘤 磁共振成像 扩散加权成像 表观扩散系数

2025

实用放射学杂志
西安市医学科学研究所

实用放射学杂志

北大核心
影响因子:1.141
ISSN:1002-1671
年,卷(期):2025.41(1)