目的：探讨颅骨腺泡状软组织肉瘤（Alveolar soft part sarcoma，ASPS）的影像学特征。资料与方法：回顾性分析8例经手术病理证实的颅骨ASPS的CT（n=8）、MRI（n=8）及MR静脉造影（MRV）（n=2）表现。结果：8例ASPS均以推压头皮软组织向外生长为主，向内则与硬脑膜分界不清。CT表现：6例原发性APSP呈溶骨性骨质破坏，见不均匀密度肿块，含斑片状残留骨质，边缘示不完整骨性薄壳；2例继发性ASPS呈溶骨性骨质破坏，肿块密度较均匀。MRI表现：6例原发性ASPS外观呈“蘑菇征”，呈以等T1、长T2、高DWI信号为主的混杂信号，内部可见片状T2WI高信号（n=6）、点条状低信号（n=4）或簇状血管影（n=2），MR增强示明显不均匀强化，并于肿瘤两侧出现“硬膜尾征”；2例继发性ASPS呈卵圆形，呈均匀等T1、等T2信号，明显均匀强化；6例原发性ASPS的ADC值平均为2.19×10-4 mm2/s，2例继发性ASPS的ADC值平均为1.76×10-4 mm2/s。MRV表现：上矢状窦受压，肿块内见大量引流静脉。结论：颅骨ASPS具有特征性的影像表现，结合其临床、病理特征，有助于本病的诊断。
?眼关键词?演 肉瘤，软组织腺泡状；颅骨肿瘤；体层摄影术，螺旋计算机；磁共振成像；磁共振血管造影术
Abstract
Objective: To investigate the imaging features of alveolar soft part sarcoma(ASPS) in skull. Materials and Methods: The CT and MRI of eight patients with ASPS in skull confirmed by pathology were analyzed retrospectively. Results: All patients were shown excentric growth with pushing the scalp soft tissue and unclear margins abutting upon duramater. On CT scanning, six primary ASPSs were shown soft tissue mass with heterogeneous density, in which contained residual bone and uncompleted bony shell(n=6). The bone destruction was mainly osteolytic destruction(n=6). Two secondary ASPSs were shown soft tissue mass with homogeneous density and osteolytic destruction(n=2). On MRI scanning, six primary ASPSs were shown mushroom sign(n=6). The tumors appeared as hyper-intensity on T2WI, iso-intensity on T1WI and hyper-intensity on DWI(n=6). There were patchy hyper intensity areas, punctual/stripy hypo-intensity areas(n=4), clustered vessel signals(n=2) in tumors on T2WI. Inhomogeneous enhancement was seen on contrast-enhanced scan in six cases. Dural tail sign was seen in both side of the tumor(n=6). Two secondary ASPSs were shown orbicular-ovate mass(n=2). The tumors appeared as iso-intensity on T2WI and iso-intensity on T1WI(n=2). Homogeneous enhancement was seen on contrast-enhanced scan in two cases. The mean ADC value of six primary ASPSs was 2.19×10-4 mm2/s. The mean ADC value of two secondary ASPSs was 1.76×10-4 mm2/s. MRV was shown superior sagittal sinus pushed with a large number of drainage veins in the tumors. Conclusion: ASPS in skull was shown some typical imaging features. Combination the imaging features, clinical findings and pathology are helpful to the diagnosis the disease.
关键词
肉瘤 /
软组织腺泡状 /
颅骨肿瘤 /
体层摄影术 /
螺旋计算机 /
磁共振成像 /
磁共振血管造影术
Key words
Sarcoma, alveolar soft part /
Skull neoplasms /
Tomography, spiral computed /
Magnetic resonance imaging /
Magnetic resonance angiography
中图分类号：
Ｒ738.6
Ｒ739.41
Ｒ814.42
Ｒ445.2
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