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目的探讨腺泡状软组织肉瘤(ASPS)的影像学表现特征,旨在提高对该类疾病的诊断水平。方法回顾性分析经手术病理证实的ASPS患者11例(男6例,女5例,年龄21~62岁,平均32.1岁),所有患者均行MRI平扫,其中4例行MR增强扫描,1例行MR增强扫描与MRA,2例行MRS扫描,2例行CTA检查。结果 ASPS在影像学上主要表现为T1WI等信号或稍高信号、T2WI混杂高信号(11/11)的软组织肿块,边界清楚,呈球形或类球形(9/11),肿瘤内外可见多发扭曲的血管流空信号(8/11)与线状低信号分隔(9/11)。增强扫描肿瘤实质部分呈明显强化(5/5)。MRA示肿瘤有丰富的供血动脉(匹配于平扫序列中的流空信号区)以及多发紊乱的引流静脉。2例1H-MRS均表现为3.2 ppm处出现明显的胆碱峰。ASPS容易发生在年轻患者;肿瘤没有特定的好发部位,但更趋向于躯干的中下段(7/11),部分患者就诊时已经发生远处转移(肺4例,脑1例,淋巴结2例)。结论 ASPS虽为罕见肿瘤,但其影像学表现及临床征象具有一定特征性,熟悉这些特点,有利于ASPS的诊断。
Objective To investigate the imaging features of acinar soft tissue sarcoma (ASPS) in order to improve the diagnosis of these diseases. Methods Retrospective analysis of 11 cases of ASPS confirmed by surgery and pathology (6 males and 5 females, aged 21-62 years, mean 32.1 years), all patients underwent MRI plain scan, of which 4 patients underwent MR enhanced scan, 1 Routine MR enhanced MRA scan, 2 routine MRS scan, 2 routine CTA examination. Results ASPS mainly manifested as T1WI signal or slightly higher signal, T2WI mixed high signal (11/11) soft tissue mass, clear boundary, spherical or spheroid (9/11), visible inside and outside the tumor multiple distorted Vascular empty signal (8/11) is separated from linear low signal (9/11). Enhanced scan substantial part of the tumor was significantly enhanced (5/5). MRA showed tumors with abundant donor arteries (matching the flow empty signal zone in the plain scan sequence) and multiple, disrupted drainage veins. Two cases of 1H-MRS showed significant choline peak at 3.2 ppm. ASPS tends to occur in young patients; the tumor has no specific site of predilection, but tends to the lower and middle segments of the trunk (7/11), and some patients have had distant metastases (4 in the lung, 1 in the brain, 2 in the lymph node ). Conclusion Although ASPS is a rare tumor, its imaging features and clinical signs have certain characteristics. Being familiar with these features is beneficial to the diagnosis of ASPS.