Sedaghat Maya, Sedaghat Sam
Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Germany.
Pol J Radiol. 2023 Jul 10;88:e325-e330. doi: 10.5114/pjr.2023.130048. eCollection 2023.
Simple MRI features are mandatory to facilitate the diagnostics of synovial sarcomas, especially for radiolo-gists outside multidisciplinary sarcoma centres. In this case-series and review, we investigate the main appearance of synovial sarcoma on MRI.
Fifteen histologically proven primary synovial sarcomas who underwent MRI at 2 different sarcoma centres were included in this case series. Patients and their primary synovial sarcomas were examined for age, localization, mean tumour size (in mm), histological grade (G - according to the Fédération Nationale des Centres de Lutte Contre Le Cancer [FNCLCC]), configuration, T2 signal intensity, presence/absence of "triple sign", heterogeneity/homogeneity, borders (well-defined or infiltrative), and intensity of contrast enhancement on MRI. Additionally, a comprehensive literature review to identify observational studies, reviews, and case-reports assessing MRI features of primary synovial sarcoma was performed.
The mean age of the patients was 47.6 years (SD: 17.2). The mean size of primary synovial sarcoma was 59.3 mm (SD: 42). Primary synovial sarcomas were significantly most often multilobulated ( = 12, < 0.01), heterogeneous ( = 10), and infiltrative ( = 9). Additionally, 3 other primary synovial sarcomas showed the following configurations: ovoid/nodular ( = 2) and fascicular ( = 1). Ovoid/nodular synovial sarcomas were solely depicted as homogeneous with well-defined borders. All tumours showed T2 hyperintense signal and presented with marked contrast enhancement.
Primary synovial sarcomas are mainly multilobulated, heterogeneous, and infiltrative tumours. In minor cases, ovoid/nodular or fascicular configurations occur. Knowing the main appearance of synovial sarcoma can help facilitate the diagnostics of primary synovial sarcomas.
简单的MRI特征对于滑膜肉瘤的诊断至关重要，特别是对于多学科肉瘤中心以外的放射科医生。在本病例系列研究及综述中，我们探究了滑膜肉瘤在MRI上的主要表现。
本病例系列纳入了15例经组织学证实的原发性滑膜肉瘤患者，这些患者在2个不同的肉瘤中心接受了MRI检查。对患者及其原发性滑膜肉瘤进行了年龄、部位、平均肿瘤大小（单位：毫米）、组织学分级（G - 根据法国国家抗癌中心联合会[FNCLCC]标准）、形态、T2信号强度、是否存在“三联征”、异质性/同质性、边界（清晰或浸润性）以及MRI上的对比增强强度等方面的检查。此外，还进行了全面的文献综述，以识别评估原发性滑膜肉瘤MRI特征的观察性研究、综述和病例报告。
患者的平均年龄为47.6岁（标准差：17.2）。原发性滑膜肉瘤的平均大小为59.3毫米（标准差：42）。原发性滑膜肉瘤最常见的是多叶状（n = 12，P < 0.01）、异质性（n = 10）和浸润性（n = 9）。另外，还有3例其他原发性滑膜肉瘤表现为以下形态：椭圆形/结节状（n = 2）和束状（n = 1）。椭圆形/结节状滑膜肉瘤仅表现为边界清晰的均匀性。所有肿瘤均表现为T2高信号，并呈现明显的对比增强。
原发性滑膜肉瘤主要是多叶状、异质性和浸润性肿瘤。少数情况下会出现椭圆形/结节状或束状形态。了解滑膜肉瘤的主要表现有助于促进原发性滑膜肉瘤的诊断。
