术前MRI评估软组织肉瘤根治术后预后

目的 观察MRI评估可切除软组织肉瘤（STS）根治术后患者预后的价值。方法 回顾性分析70例经病理证实STS且接受根治术患者的术前MRI,测量肿瘤大小,观察肿瘤T2信号均匀程度、肿瘤强化程度以及是否存在瘤周水肿、瘤周强化、血管/神经或骨质侵犯等征象,分析无进展生存期（PFS）,对相关影响因素进行单因素及多因素分析。结果 随访中14例（14/70,20.00%）局部复发,22例（22/70,31.43%）远处转移,中位进展时间22个月,第1、2、3年PFS患者占比分别为62.86%（44/70）,51.43%（36/70）及51.43%（36/70）。年龄、病理分级、术前接受治疗与否、肿瘤长径、T2信号均匀程度、存在瘤周水肿与否、瘤周强化、血管/神经或骨质侵犯、筋膜尾征及不同区域浸润是STS根治术后PFS的影响因素（P均<0.05）;肿瘤长径、是否存在瘤周强化、血管/神经或骨质侵犯是STS根治术后PFS的独立影响因素（P均<0.05）。结论 MRI对预测可切除STS患者预后具有重要价值;肿瘤长径、是否存在瘤周强化、血管/神经或骨质侵犯是术后PFS的独立影响因素。

Evaluation on prognosis of soft tissue sarcomas after surgery with preoperative MRI

Objective To explore the value of preoperative MRI in evaluating prognosis of resectable soft tissue sarcomas (STS) after surgery. Methods Data of 70 STS patients confirmed pathologically who underwent radical surgery and preoperative MRI were retrospectively analyzed. The tumor sizes were measured, signal intensity heterogeneity at T2WI, tumor enhancement, peritumoral edema, peritumoral enhancement, vascular/nerve or bone invasion and other signs on MRI were evaluated. The progression free survival (PFS) were evaluated, and the impact factors of PFS after radical surgery of STS were analyzed by using univariate and multivariate analyses. Results Among 70 patients, local relapses and metastatic relapses occurred in 14 (14/70, 20.00%) and 22 cases (22/70, 31.43%) during follow-up. The median progression time was 22 months, and 1-, 2- and 3-year PFS was 62.86% (44/70), 51.43% (36/70) and 51.43% (36/70), respectively. Age, histological grade, preoperative therapy, the longest diameter of tumor, signal intensity heterogeneity at T2WI, peritumoral edema, peritumoral enhancement, vascular/nerve or bone invasion, tail sign and intercompartmental extension were the impact factors for PFS of STS after radical surgery (all P<0.05). The longest diameter of tumor, peritumoral enhancement and vascular/nerve or bone invasion were independent predictors for PFS of STS patients after radical surgery (all P<0.05). Conclusion MRI had important predictive value for prognosis of resectable STS. The longest diameter of tumor, peritumoral enhancement and vascular/nerve or bone invasion were independent predictors for PFS of STS patients after radical surgery.