下肢软组织肿块的影像诊断及鉴别

目的]分析下肢软组织肿块的影像表现特点,以提高对其诊断和鉴别诊断水平.方法]回顾性分析经手术和病理证实的71例下肢软组织肿块的临床及影像学表现,男44例,女27例,年龄36 ～ 78岁,平均56岁；病程:2周～21年；CT检查28例,MRI检查43例；重点回顾肿块的部位、数目、大小、形态特征、密度或信号强度及与周围组织关系.结果]神经鞘瘤20例,腱鞘囊肿8例、滑膜囊肿8例,肌肉内血管瘤4例,脂肪瘤7例,脂肪肉瘤5例,血肿及血肿伴机化11例,粘液瘤3例、纤维瘤病2例、恶性纤维组织细胞瘤2例、增生性肌炎1例；下肢软组织肿块的CT特点是低密度肿块为主,MRI表现各异.结论]大多数下肢软组织肿块的影像表现具有特征性,正确认识其影像表现及结合临床病史,有助于提高该病的诊断和鉴别诊断水平.

Imaging and differential diagnosis of lower extremity soft tissue masses

【Objective】 To analyze the appearances of image of lower extremity soft tissue masses for improving the ability of diagnosis and differential diagnosis.【Methods】 The clinical and image appearances of 71 cases of lower extremity soft tissue masses confirmed by surgery and pathology were analyzed retrospectively,there were 44 males and 27 females,the age of the patients ranged from 36 to 78years with an average age of 56 years;the disease course were 2 weeks to 21 years;Twenty-nine cases were examined with CT and 43 cases with MRI.The tissue masses were observed according to the location,number,size,morphological characteristics,density or signal intensity,and the relationship of surrounding tissues.【Results】 There were 20 nerve sheath tumors,8 ganglionic cyst,8 synovial cyst,4 intramuscular angioma,7 lipoma,5 liposarcoma,11 hematomas and hematomas accompany with organiation,3 myxoma,2 fibromatosis,2 malignant fibrous histiocytomas and 1 proliferative myositis,The CT features of lower extremity soft tissue masses were low density masses and variable on MRI.【Conclusion】 Most lower extremity soft tissue masses have characteristic fingings on image,Correctly realize the image appearances and combine with the clinical history,may be helpful in the diagnosis and differential diagnosis.