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1、磁共振成像对软组织肿瘤的诊断作者:王宁,马红强,许洋,张林医,崔现成【摘要】 目的探讨MRI对软组织肿瘤的诊断价值。方法回顾性分析2002—2006年经手术病理或穿刺证实的软组织肿瘤160例的MRI资料,男98例,女62例;年龄3~75岁,平均32岁;临床均以软组织肿胀、肿块伴或不伴疼痛为主要征象。采用PhlipsGyroscanIntera15TmasterMR机,表面线圈、E线圈、C1线圈,采用快速自旋回波序列,脂肪抑制序列,矢状位、冠状位及横断位扫描及增强扫描,160例软组织肿瘤中,良性120例,其中脂肪瘤30例,肌肉血管瘤25例,腱鞘巨细胞瘤30例,神经源性
2、肿瘤20例,硬纤维瘤15例;软组织恶性肿瘤40例,其中脂肪肉瘤16例,恶性纤维组织细胞瘤11例,平滑肌肉瘤6例,纤维肉瘤3例,淋巴瘤2例,黑色素瘤2例。结果良性肿瘤直径为1~16cm,边缘光滑、规则,信号均匀,增强均匀强化或不强化;恶性肿瘤直径5~12cm,形态不规则,多呈分叶状,信号不均匀,累及周围结构,强化明显且不均匀。结论MRI对软组织肿瘤检查敏感性高,肿瘤的发病部位及某些特征有助于诊断及鉴别诊断,对脂肪瘤及黑色素瘤的诊断有特异性。【关键词】磁共振成像;软组织肿瘤;诊断 Abstract:ObjectiveToinvestigatethediagnosticv
3、alueofmagneticresonanceimaging(MRI)inthetumorofsofttissue.MethodsAtotalof160patients[98malesand62females;meanage32years(agerange3-75)]withsofttissuetumorconfirmedbypathologicalfindingswereadmittedtothehospitalfromtheyearof2002to2007.Themainclinicalmanifestationsweresofttissueswellingand
4、masswithorwithoutpain.AllthepatientwereexamedwithMRI(PhilipsGyroscanIntera15Tmaster),SurfaceCoil,ECoilandC1Coil.MRIexaminationwasperformedbyFastspinecho(FSE)sequences,fatinhibitionsequences,andcoronal,sagittalandaxialplanes.Ofthe160cases,therewere30withlipoma,25withmusclevasculartumor,3
5、0withgiantcelltumoroftendonsheath,20withneuraltumor,15withfibroustumorand40withmalignanttumorincluding16withliposarcoma,11withmalignantfibroushistiocytoma,6withleiomyosarcoma,3withfibrosarcomas,2withlymphomaand2withmelanoma.ResultsThebenigntumorswas1-16cmindiameter,andsmoothandregularin
6、shape,withahomogeneousdensitywithuniformenhancementorwithoutenhancement.Themalignanttumorswas5-12cmindiameter,andirregularandlobularinshape,withheterogeneousdensity,peritumorinfiltrationandobviousandheterogeneousenhancement.ConclusionMRIishighlysensitivetosofttissuetumors.Thelocationand
7、somecharacteristicsignsarehelpfulfordiagnosisanddifferentiation,especiallyforthediagnosisoflipomaand4melanoma. Keywords:magneticresonanceimaging;softtissuetumor;diagnosis软组织肿瘤手术前判断其良、恶性非常重要。在MRI技术出现前,对软组织病变临床大多采用X线片、CT、或超声检查作为影像学的诊断依据,但由于它们对软组织分辨率差,所以软组织肿瘤的检出率低,随着MRI技术的普及和扫描序列