Bancroft Laura W, Pettis Christopher, Wasyliw Christopher
Department of Radiology, Florida Hospital, Orlando, FL 32803, USA.
Semin Musculoskelet Radiol. 2013 Apr;17(2):156-67. doi: 10.1055/s-0033-1343071. Epub 2013 May 14.
The evaluation of soft tissue tumors should be approached systematically, with careful assessment of the patient's age, clinical presentation, anatomical location of the mass, and MRI characteristics. The imaging evaluation of a suspected soft tissue mass begins with conventional radiography to exclude an underlying osseous lesion and assess for any lesional calcification. MRI is particularly useful in evaluating the signal intensity, enhancement pattern, and extent of soft tissue masses that can expand beyond fascial planes and involve the neurovascular bundle, joint, or bone. Among the common benign soft tissue tumors, a fairly definitive imaging diagnosis can be made in cases of lipoma, elastofibroma dorsi, hemangiomas, myositis ossificans, giant cell tumor of tendon sheath, and peripheral nerve sheath tumors. In the remaining cases, the differential diagnosis can be narrowed by knowing the patient's demographics and any associated syndromes, in conjunction with recognizing specific MRI features. Knowledge of the World Health Organization's tumor designations and the incidence of specific tumors based on patient age and anatomical location are vital tools for the interpreting radiologist.
软组织肿瘤的评估应系统进行,需仔细评估患者的年龄、临床表现、肿块的解剖位置以及磁共振成像(MRI)特征。对疑似软组织肿块的影像学评估始于传统X线摄影,以排除潜在的骨病变并评估是否存在病变钙化。MRI在评估软组织肿块的信号强度、强化方式以及范围方面特别有用,这些肿块可能超出筋膜平面并累及神经血管束、关节或骨骼。在常见的良性软组织肿瘤中,脂肪瘤、背侧弹力纤维瘤、血管瘤、骨化性肌炎、腱鞘巨细胞瘤和周围神经鞘瘤等病例可做出较为明确的影像学诊断。在其余病例中,通过了解患者的人口统计学特征和任何相关综合征,并结合识别特定的MRI特征,可缩小鉴别诊断范围。了解世界卫生组织的肿瘤命名以及基于患者年龄和解剖位置的特定肿瘤发病率,是解读放射科医生的重要工具。