李鹏飞,孟帆,冯贺新.腺泡状软组织肉瘤影像学表现[J].中国医学影像技术,2024,40(6):907~911
腺泡状软组织肉瘤影像学表现
Imaging manifestations of alveolar soft part sarcoma
投稿时间:2024-01-30  修订日期:2024-02-25
DOI:10.13929/j.issn.1003-3289.2024.06.023
中文关键词:  肉瘤,软组织腺泡状  肿瘤转移  诊断显像
英文关键词:sarcoma, alveolar soft part  neoplasm metastasis  diagnostic imaging
基金项目:
作者单位E-mail
李鹏飞 内蒙古民族大学附属医院影像中心, 内蒙古 通辽 028000 13848869320@163.com 
孟帆 郑州大学附属肿瘤医院影像科, 河南 郑州 450000  
冯贺新 中国医科大学附属盛京医院影像科, 辽宁 沈阳 110001  
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中文摘要:
      目的 观察腺泡状软组织肉瘤(ASPS)的影像学表现。方法 回顾性分析21例经手术病理证实的ASPS患者CT、MRI及PET/CT资料,观察其影像学表现。结果 21例ASPS原发灶均单发,多位于下肢(9/21,42.86%)及盆腔(5/21,23.81%),平均最大径(72.10±42.23)mm;CT平扫均呈等-低不均匀密度肿物(9/9,100%),增强扫描后明显不均匀强化(6/6,100%),3例见增粗血管影(3/6,50.00%)、以瘤体上/下极为著;MR平扫均呈T1WI等-稍高信号、T2WI及弥散加权成像(DWI)混杂高信号、表观弥散系数(ADC)图低信号(18/18,100%),15例可见病灶内囊变坏死区及T2WI流空血管(15/18,83.33%),增强后肿块不均匀强化,囊变坏死区无强化而流空血管处明显强化(9/9,100%);PET/CT示4例(4/4,100%)FDG摄取增高,最大标准摄取值为4.2~7.9。21例中,19例(19/21,90.48%)出现远处转移,以肺(17/21,80.95%)、骨(11/21,52.38%)及淋巴结(6/21,28.57%)转移最常见。结论 ASPS好发于下肢及盆腔,易发生远处转移;原发灶影像学多表现为密度不均匀的较大肿物,瘤体上、下极增粗血管为其相对特征性表现。
英文摘要:
      Objective To observe the imaging manifestations of alveolar soft part sarcoma (ASPS). Methods CT, MRI and PET/CT data of 21 patients with pathologically confirmed ASPS were retrospective reviewed, and the imaging findings were analyzed. Results All 21 cases of ASPS presented as single primary lesion, mostly located in lower limbs (9/21, 42.86%) and pelvis (5/21, 23.81%), with the average maximum diameter of (72.10±42.23)mm. On non-contrast CT imaging, primary lesions appeared as iso-low inhomogeneous density masses (9/9, 100%), which obviously heterogeneously enhanced in 6 cases (6/6, 100%). Enlarged blood vessel shadows were noticed in 3 cases (3/6, 50.00%), especially upper/lower pole of the tumors. The primary lesions presented as iso-slight high signals on non-contrast T1WI, mixed high signals on both T2WI and diffusion weighted imaging (DWI), as well as low signals on apparent diffusion coefficient (ADC) images (18/18, 100%), with necrosis and cystic areas within the tumor and empty blood vessel shadows in 15 cases (15/18, 83.33%). Heterogeneous enhancement of primary lesions were detected in 9 cases (9/9, 100%), while necrosis and cystic areas did not enhance, but empty blood vessel shadows obviously enhanced. PET/CT demonstrated increased FDG uptake in 4 cases (4/4, 100%), with the maximum standard uptake value ranged from 4.2 to 7.9. Among 21 cases, distant metastases developed in 19 (19/21, 90.48%), most frequently to lungs (17/21, 80.95%), bones (11/21, 52.38%) and lymph nodes (6/21, 28.57%). Conclusion ASPS usually occurred in lower limbs and pelvis, which was prone to distant metastasis. The imaging manifestations of primary ASPS mostly presented as large tumors with uneven density, and enlarged blood vessel above and below the tumor were the relative characteristic performances.
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