四肢腺泡状软组织肉瘤MRI诊断

目的 探讨腺泡状软组织肉瘤(ASPS)的MRI表现特征.方法 搜集经手术、病理证实的6例ASPS患者的影像学资料,分析其MRI表现.结果 女5例,男1例,中位年龄(17.67 ±2.63)岁.肿瘤发生位置:上肢1例,大腿4例,小腿1例.MRI显示肿瘤体积较大,边界清晰,肿瘤实质内、肿瘤边缘或周围可见大量蜿蜒迂曲的流空血管.T1 WI和T2 WI均为高信号,增强后明显强化.病理显示大量多边形肿瘤细胞围成肿瘤巢,呈腺泡样排列,PAS染色阳性,CD34染色显示细胞巢之间的血窦内皮细胞阳性.结论 ASPS为富血供恶性肿瘤,其临床、MRI及病理表现具有一定特征性.     

骨原发性腺泡状肉瘤

以往认为腺泡状肉瘤只发生于软组织，本文报告经手术病理证实的骨原发性腺泡状肉瘤6例，其中5例为单发病变，1例为多发病变。     

骨原发性腺泡状肉瘤

腺泡状软组织肉瘤是一种较为罕见的恶性肿瘤,至今组织来源未明。既往一般认为该肿瘤仅发生在软组织,近年来研究证明其不仅发生在软组织,而且也原发在骨内。继1983年     

软组织和骨腺泡状肉瘤

腺泡状肉瘤(Alvelar sarcoma)是一种组织来源不明、名称繁多、起病缓慢、具有特殊病理形态特征的一类肿瘤。过去人们认为该肿瘤仅发生在肌肉内,故称为软组织腺泡状肉瘤(国外报道约215例,国内近82例),但近10年来,国内报道腺泡状肉瘤亦可原发于骨内,称为骨腺泡状肉瘤(约14例,国外尚无此类报道)。     

腺泡状软组织肉瘤的MRI表现

目的：探讨腺泡状软组织肉瘤的MRI表现。方法：9例手术病理证实的腺泡状软组织肉瘤,术前均进行MRI平扫,其中4例行增强扫描,2例行1H-MRS扫描。对肿瘤的发生部位、大小、肿瘤形态、肿瘤的强化和1H-MRS表现进行分析评价。结果：位于大腿4例,小腿2例,上臂2例,臀肌和髂腰肌1例,8例肿瘤位于深部肌群;肿瘤体积平均大小5.1 cm×7.8 cm;5例呈分叶状;3例肿瘤周围有软组织结节;7例肿瘤的信号均匀,呈中等T1长T2信号,2例有囊变坏死;4例增强扫描者,瘤实质明显强化;2例1H-MRS均表现为3.2 ppm出现明显的Cho峰。结论：腺泡状软组织肉瘤的MRI表现缺乏特异性,但在一定程度上能够反应肿瘤的恶性特点,对于术前肿瘤定性诊断和指导临床治疗具有一定价值。     

宝石能谱CT结合MRI诊断腺泡状软组织肉瘤1例

患者男,32岁。半年前无明显诱因下发现左大腿后方有一包块,并逐渐增大。体检：肿块质硬,无红肿、疼痛。实验室各项检查未见明显异常。 能谱CT 表现：左侧大腿外后侧股二头肌长、短肌区可见一巨大类圆形软组织肿块影,浅分叶,大小约5．7cm ×6.2cm ×10．1cm ,平扫密度略低于肌肉,与周围肌肉分界欠清;增强动脉期肿块整体迅速明显强化,肿块内见多支弯曲的血管影及线状低密度分隔,动脉期左侧股静脉较对侧早显,静脉期及延迟期病灶呈持续性强化,且于静脉期可见包膜样结构强化。CT血管成像（CTA）：左侧股深动脉粗大分支、腘动脉膝上外侧动脉及膝下动脉向肿块供血,肿块内见扭曲的、粗细不均的异常肿瘤血管,静脉期可见多支粗大的引流静脉汇向左侧股静脉及大隐静脉。M RI表现：T1 WI肿块呈稍高信号,T2 WI呈明显高信号,内见星芒状低信号分隔,肿块内及其后上方的皮下和肌间隙受侵并见多根流空血管影;增强后肿块明显不均匀强化。     

骨腺泡状软组织肉瘤一例

骨腺泡状软组织肉瘤一例施增儒，王金林，包聚良，刘会敏腺泡状软组织肉瘤（Ａｉｖｅｏｌａｒｓｏｆｔ－ｐａｒｔＳａｒｃｏｍａ）是一种组织来源不甚明确的罕见肿瘤。文献记载肿瘤均位于深部肌肉或肌膜上，一般为单发亦可多发。我们发现一例可能起自骨干的多发性病灶，报...     

原发性骨腺泡状肉瘤一例

患者女，70岁。2年前无明显诱因出现左肩部持续性疼痛，夜间明显，肩关节活动轻微受限。6个月前疼痛加重，并出现1个进行性增大的肿物。体检：左肩关节活动受限，左肩胛部有一肿物，质硬，活动度差，边界不清，有压痛，局部皮温高，皮肤发红，表面无破溃，距肩峰下3cm处。X线表现（图1）：左肩胛骨骨质大部分破坏消失，残留部分关节盂，     

原发性骨淋巴瘤CT及MRI诊断

目的探讨原发性骨淋巴瘤CT及MRI表现,以提高对该病的诊断水平。方法回顾性分析12例经临床病理证实的原发性骨淋巴瘤的影像学资料。结果12例原发性骨淋巴瘤中10例为B细胞源性,2例为T细胞源性。侵犯骨盆3例,椎体3例,肋骨2例,胸骨2例,颅骨2例。CT及MRI扫描中,9例原发性骨淋巴瘤单发。3例原发性骨淋巴瘤多骨发生。其中溶骨型7例,浸润型3例,混合型2例,均合并有病理性骨折。颅骨2例均部分形成软组织肿块。MRI表现为T1wI呈等或低信号,T1wI呈等或稍高信号。结论原发性骨淋巴瘤的CT和MRI表现具有一定特征性,有助于诊断和鉴别诊断。     

原发性肛管直肠恶性黑色素瘤的CT和MRI表现

目的：探讨原发性肛管一直肠恶性黑色素瘤（AMM）的CT和MRI表现。方法：回顾性分析本院经病理证实的15例AMM患者的临床、CT、MRI和病理资料。11例行CT检查,3例行MRI检查,1例行CT和MRI检查。结果：15例AMM中,10例病变位于直肠远端与肛管交界处,2例位于直肠,3例位于肛管。肿瘤形态呈蕈伞形肿块9例,肠壁环形增厚4例,肠壁未见明显增厚2例。4例有肺部或者肝脏转移,5例有周围淋巴结转移。15例患者均未见明星的肠梗阻征象。CT平扫示肿块呈稍低密度,最大径约2～4cm,增强后强化方式不一,以中度强化为主。MRI示肿瘤在T2wI上以等信号为主,T2wI上以稍高信号为主,DWI上呈高信号,增强后均有明显强化。结论：AMM的CT和MRI表现具有一定特征性;但AMM病灶较大时,MRI信号不具有黑色素瘤特异性的典型信号。CT检查有助于发现远处转移灶,MRI检查对其鉴别诊断有提示价值。     

MRI of alveolar soft-part sarcoma

Alveolar soft-part sarcoma (ASPS) is rare. We present a case of a 30-year-old woman with a 6-month history of a palpable mass in her left thigh. MRI showed an 8-cm mass and a satellite nodule at the left gluteus muscle. The main tumor exhibited an isointense signal on T1-weighted images and high-signal-intensity areas with low-signal-intensity scanty solid components on T2-weighted images. MR angiography showed dilated and tortuous veins around the tumor. Histologic findings were compatible with ASPS.     

Infratemporal alveolar soft part sarcoma: CT,MRI and angiographic findings

Summary The imaging features of a rare alveolar soft part sarcoma found in a 44-year-old female are presented. Although the tumor showed hypervascularity by angiography, CT and MRI suggested slow growth. Despite this relatively benign appearance, alveolar soft part sarcoma is one of the most malignant sarcomas.     

地中海贫血性骨病变的CT、MRI表现

目的:探讨地中海贫血性骨病变的CT、MRI表现及诊断要点,提高该病的诊断水平。方法:回顾性分析17例地中海贫血性骨病变的CT、MRI资料,结合文献,探讨其影像特点及鉴别诊断。结果:17例胸腰椎椎体及附件均受累,其中4例合并颅骨病变,2例合并股骨及胫腓骨病变,5例合并肋骨、胸骨及肩胛骨病变。MRI见骨髓弥漫性信号异常,T_1WI骨髓高信号弥漫性降低,T_2WI呈等信号,STIR T_2WI呈高信号。CT示胸腰椎椎体呈栅栏状改变,骨小梁减少、增粗;其中5例肋骨、胸骨及肩胛骨膨胀改变,4例颅骨板障增厚、板障间呈放射状排列骨小梁;合并椎旁软组织肿块11例,合并肋骨旁软组织肿块4例,增强扫描肿块轻度均匀强化,穿刺活检示髓外造血组织。结论:地中海贫血性骨病变影像学表现有一定的特征,结合病史,可作出正确诊断。     

The radiologic manifestations of alveolar soft-part sarcoma

Alveolar soft-part sarcoma is a rare soft-tissue tumor of unknown cellular origin that is characterized histologically by its organized "pseudoalveolar" pattern. The radiologic findings in 11 patients with this neoplasm were reviewed. The six men and five women were 16-48 years old (mean, 27 years). Nine patients had untreated primary tumors (thigh, four; forearm, two; and buttock, rectus abdominis muscle, and infratemporal fossa, one each) and two had locally recurrent masses (one each in the retroperitoneum and retrocrural space). All patients were evaluated by conventional radiography, two by sonography, eight by CT, five by angiography, and three by MR. Conventional radiographs showed the soft-tissue mass in only four patients; four lesions caused destruction of adjacent bone and two had soft-tissue calcification. Unenhanced CT showed low-attenuation lesions in four of five patients. The lesions were hypervascular on contrast-enhanced CT or angiography in each of nine patients studied. Prominent draining veins were shown by CT or angiography in five patients. Three lesions had a prolonged capillary stain on angiography. Alveolar soft-part sarcoma should be considered in the differential diagnosis of a hypervascular soft-tissue mass, particularly in the thigh of a young adult.     

肺泡蛋白沉积症的CT表现

目的:探讨肺泡蛋白沉积症(PAP)的CT表现,提高对本病的认识。方法:回顾性分析13例经病理证实的PAP患者的CT资料。结果:PAP具有特征性的CT表现:地图征10例,铺路石征8例,磨玻璃征8例,蝶翼征2例及支气管充气征1例,以上征象联合出现时强烈提示本病。结论:PAP临床罕见,其CT表现具有一定特征,结合临床可与其它肺部疾病相鉴别,并提高本病的诊断水平。     

CT manifestations of pumonary alveolar proteinosis

目的:探讨肺泡蛋白沉积症(PAP)的CT表现,提高对本病的认识.方法:回顾性分析13例经病理证实的PAP患者的CT资料.结果:PAP具有特征性的CT表现:地图征10例,铺路石征8例,磨玻璃征8例,蝶翼征2例及支气管充气征1例,以上征象联合出现时强烈提示本病.结论:PAP临床罕见,其CT表现具有一定特征,结合临床可与其它肺部疾病相鉴别,并提高本病的诊断水平.     

MRI and CT evaluation of primary bone and soft-tissue tumors

Twenty-six patients with primary tumors of bone or somatic soft tissues underwent both magnetic resonance imaging (MRI) and computed tomography (CT); 15 of the patients had radionuclide bone scans as well. Only in a minority of cases did these tomographic methods provide information needed for diagnosis that could not be derived from the plain radiographs alone; however, for assessing the extent of the disease, both CT and MRI proved very valuable, particularly MRI. Specifically, MRI was superior to CT in delineating the extent of the neoplasms and their relation to surrounding structures in 21 of the patients, equal in four, and inferior in only one. Furthermore, in the 13 patients with tumors of long bone, MRI was judged superior to CT in visualizing marrow abnormality in 12 cases, and equal in only one case. Radionuclide scans demonstrated the lesions in 14 of the 15 cases; its primary utility was in excluding additional lesions. It is concluded that for these patients, MRI was the imaging method of choice in assessing the extent of bone and soft-tissue tumors.