Beaman Francesca D, Jelinek James S, Priebat Dennis A
Department of Radiology, Musculoskeletal Division, University of Kentucky, Lexington, KY 40536, USA.
Semin Musculoskelet Radiol. 2013 Apr;17(2):168-76. doi: 10.1055/s-0033-1343094. Epub 2013 May 14.
Soft tissue tumors are histologically classified based on the tissue type they reflect. MR and computed tomography imaging remains the mainstay for the evaluation of a soft tissue mass including guiding the biopsy to the most aggressive portion of the lesion, tumor staging, and evaluating local recurrence and metastatic disease. Although some lesions may be readily identified based on their imaging characteristics, many soft tissue tumors remain indeterminate and require biopsy for diagnosis of histologic type and lesion grade, factors that have an impact on therapeutic options and long-term disease-free survival.In this article we review the current literature regarding imaging and treatment of soft tissue lesions in the musculoskeletal system. Positron emission tomography and specialized MR techniques, such as spectroscopy and diffusion-weighted imaging, are useful in the diagnosis of high-grade soft tissue sarcomas, although imaging overlap exists with benign and low-grade sarcomas. These modalities are proving useful in primary tumor staging, evaluation of therapeutic response, and metastatic disease assessment. We also discuss the roles of percutaneous ablation in the treatment of focal disease and palliative pain control, and review current targeted cancer therapies.
软组织肿瘤根据其反映的组织类型进行组织学分类。磁共振成像（MR）和计算机断层扫描成像仍是评估软组织肿块的主要手段，包括引导活检至病变最具侵袭性的部位、肿瘤分期以及评估局部复发和转移性疾病。尽管一些病变可根据其影像学特征轻松识别，但许多软组织肿瘤仍不明确，需要进行活检以诊断组织学类型和病变分级，这些因素会影响治疗选择和长期无病生存率。在本文中，我们回顾了关于肌肉骨骼系统软组织病变的影像学和治疗的当前文献。正电子发射断层扫描和专门的MR技术，如光谱学和扩散加权成像，在高级别软组织肉瘤的诊断中很有用，尽管在良性和低级别肉瘤中也存在影像学重叠。这些方法在原发性肿瘤分期、治疗反应评估和转移性疾病评估中已证明很有用。我们还讨论了经皮消融在治疗局限性疾病和缓解疼痛方面的作用，并回顾了当前的靶向癌症治疗方法。
