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Возможности комплексного ультразвукового исследования и магнитно-резонансной томографии в дифференциальной диагностике сарком мягких тканей: корреляция с гистологическими данными

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Литература:

Possibilities of Ultrasonography and Magnetic Resonance Imaging in Differential Diagnostics of Soft Tissue Sarcomas: Correlation with Histological Data

Soft tissue sarcomas of mesenchimal origin constitute no more then 1% of the total number of malignant tumors. The aim of our study was the perfection of the soft tissue tumors diagnosis and elaboration of ultrasound (US) and magnetic resonance imaging (MRI) criteria in the differentiation of malignant and benign soft tissue tumors. Materials and Methods: 107 patients with the primary malignant soft tissue tumors were studied. Among them 31 (29%) cases of fibrosarcoma, 21 (20%) cases of liposarcoma, sinovial sarcoma – 13 (12%), leiomiosarcoma 11 (10%), malignant schwannoma (neirofibrosarcoma) – 9 (8%), rabdomiosarcoma – 8 (7%), angiosarcoma – 7 (6.5%), malignant soft tissue fibrohistiocitoma – 7 (6.5%). The age of the patients varied between 8 and 52. Males – 68 (71.6%), females – 39 (28.4%). All the patients underwent colour/power Doppler ultrasound (CDUS) and magnetic resonance imaging (MRI) with contrast enhancement. Results: Small tumors, (5 cm), were diagnosed in 33 (31%) cases. In other patients the tumor dimensions varied between 5 and 22 cm. CDUS allow to assess, that unlike benign formations, malignant tumors belong to highly vascular types of tumors. Neovascularization (47 patients) was localized frequently at tumor's periphery, less frequently – in the central area. Neovascularization in 83 (78%) cases consisted in curved arteries, with well developed branching. MRI with contrast enhancement in 63 cases confirmed hypervascularization of the sarcomas. Nonhomogeneous enhancement and a prolonged delay of contrast agent in its central and peripheral sections, pointed clearly to the presence of hypervascularization of a tumor. Conclusion: Our data gives us possibility to conclude that CDUS and MRI are highly informative methods for the assessment of soft tissue tumors.

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