CAJ | 학술논문

　　目的探讨软组织滑膜肉瘤（primary synovial sarcoma,PSS）的CT和MRI影像学诊断价值。方法回顾性总结PSS影像学表现特征，重点分析误诊的8例PSS（肢体5例、盆区3例），对照病理分析影像学表现。结果8例误诊（低估）PSS（术后病理学高、中、低分化各占1、5、2例）。瘤灶分叶，肿块偏实性，直径＞5 cm，灶内分隔，增强扫描不均匀强化6例，肺和邻近淋巴结转移2例。CT对灶内出血、细小钙化和皮质破坏较敏感；MRI更清晰准确定位，显示灶内多重复杂信号征象（纤维、液、脂和出血）及骨髓水肿等特点。结论 PSS除了巨块、分叶、分隔、骨侵蚀和转移等常见恶性特征外，瘤体不均质与分化程度有一定相关，CT和MRI发现早期恶性征象，确诊有重要价值和互补作用。
　　목적탐토연조직활막육류（primary synovial sarcoma,PSS）적CT화MRI영상학진단개치。방법회고성총결PSS영상학표현특정，중점분석오진적8례PSS（지체5례、분구3례），대조병리분석영상학표현。결과8례오진（저고）PSS（술후병이학고、중、저분화각점1、5、2례）。류조분협，종괴편실성，직경＞5 cm，조내분격，증강소묘불균균강화6례，폐화린근림파결전이2례。CT대조내출혈、세소개화화피질파배교민감；MRI경청석준학정위，현시조내다중복잡신호정상（섬유、액、지화출혈）급골수수종등특점。결론 PSS제료거괴、분협、분격、골침식화전이등상견악성특정외，류체불균질여분화정도유일정상관，CT화MRI발현조기악성정상，학진유중요개치화호보작용。
Objective To investigate the iconography diagnostic value of computed tomography(CT)and magnetic resonance imaging(MRI) in primary synovial sarcoma(PSS) of the soft tissue.Methods To study PSS iconography features retrospectively,focus analysis was misdiagnosis 8 PSS patients (5 cases in Limbs,3 cases in pelvis area) imaging features comparative with pathology.Results The patholology of 8 misdiagnosis cases,high,middle and low differentiation were 1,5,2 cases each.Tumor foci leaf,partial solid,tumor diameter greater than 5 cm,separated foci,enhanced scan heterogeneous enhancement (6 cases),had metastases of lung and adjacent lymph nodes(2 cases).CT in the bleeding lesions, petty calciifcation and cortical destruction is sensitive;MRI is more clear and accurate positioning,display within the multiple complex signal sign (ifber,lfuid,fat and bleeding) and bone marrow edema and so on. Conclusion PSS except bulk,lobulated,segregation and erosion or metastasis for commom malignant features,the tumor was heterogeneity related with degree of differentiation. CT and MRI found malignant signs in early stage had great value and complementary role for accurate diagnosis.