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    软组织肿瘤的影像诊断仍然是肌肉骨骼放射学中的一个挑战，其困难归因于软组织肿瘤的多样性及其影像表现的重叠性。随着影像学技术的不断发展，软组织肿瘤的成像取得了显著进展，影像学目前在软组织肿瘤的检测、诊断和治疗方案制订中起着关键作用。

    本书采用2013年世界卫生组织（WHO）制订的软组织肿瘤分类对软组织肿瘤进行分类讨论，包括软组织肿瘤的诊断方法、步骤等，以及各类软组织肿瘤的影像学表现、病变特征、诊断征象等。

    本书旨在让读者熟悉软组织肿瘤的影像学表现和分析思路，提高对软组织肿瘤的理解，运用分析技巧，在临床实践中做出精确诊断。

第一部分　软组织肿瘤诊断总论
第1章　诊断方法...............................................002
1.1　临床分析.................................................002
1.2　成像方法.................................................003
1.3　良性与恶性...............................................005
1.4　示例：诊断方法...........................................006

第2章　诊断步骤...............................................018
2.1　解剖间室.................................................018
2.2　影像引导下经皮活检.......................................019
2.3　示例：诊断步骤...........................................021

第3章　软组织肉瘤分期.........................................027
3.1　原发肿瘤（T分期）........................................027
3.2　区域淋巴结（N-分期）.....................................028
3.3　远处转移（M分期）........................................029
3.4　组织学分级（G分级）......................................029
3.5　推荐的报告格式...........................................029
3.6　示例：软组织肉瘤的分期...................................030

第二部分　软组织肿瘤的WHO分类及影像学表现
第4章　脂肪细胞肿瘤...........................................038
4.1　脂肪瘤...................................................038
4.2　脂肪瘤病.................................................039
4.3　神经脂肪瘤病.............................................039
4.4　脂肪母细胞瘤/脂肪母细胞瘤病..............................040
4.5　血管脂肪瘤...............................................040
4.6　梭形细胞脂肪瘤...........................................040
4.7　冬眠瘤...................................................041
4.8　树枝状脂肪瘤.............................................041
4.9　非典型脂肪瘤样肿瘤/高分化脂肪肉瘤........................041
4.10　去分化脂肪肉瘤..........................................042
4.11　黏液样脂肪肉瘤..........................................042
4.12　多形性脂肪肉瘤..........................................043
4.13　示例：脂肪细胞肿瘤......................................044

第5章　纤维母细胞/肌纤维母细胞性肿瘤..........................063
5.1　结节性筋膜炎.............................................063
5.2　增生性筋膜炎.............................................064
5.3　增生性肌炎...............................................064
5.4　骨化性肌炎...............................................064
5.5　弹力纤维瘤...............................................065
5.6　婴儿纤维错构瘤...........................................065
5.7　颈部纤维瘤病.............................................066
5.8　腱鞘纤维瘤...............................................066
5.9　促结缔组织增生性纤维母细胞瘤............................ 066
5.10　钙化性腱膜纤维瘤........................................067
5.11　掌/跖纤维瘤病...........................................067
5.12　韧带样纤维瘤病..........................................068
5.13　隆突性皮肤纤维肉瘤......................................068
5.14　孤立性纤维性肿瘤........................................068
5.15　炎性肌纤维母细胞性肿瘤..................................069
5.16　黏液纤维肉瘤............................................069
5.17　低级别纤维黏液样肉瘤....................................070
5.18　低级别肌纤维母细胞肉瘤..................................070
5.19　硬化性上皮样纤维肉瘤....................................070
5.20　示例：纤维母细胞/肌纤维母细胞性肿瘤.....................071

第6章　所谓的纤维组织细胞性肿瘤...............................108
6.1　腱鞘滑膜巨细胞瘤.........................................108
6.2　深部良性纤维性组织细胞瘤.................................109
6.3　软组织巨细胞瘤...........................................109
6.4　示例：所谓的纤维组织细胞性肿瘤...........................110

第7章　平滑肌肿瘤.............................................121
7.1　深部软组织平滑肌瘤.......................................121
7.2　平滑肌肉瘤...............................................121
7.3　示例：平滑肌肿瘤.........................................122

第8章　周细胞（血管周细胞）肿瘤...............................131
8.1　血管球瘤.................................................131
8.2　肌周细胞瘤（包括肌纤维瘤）...............................132
8.3　血管平滑肌瘤.............................................132
8.4　示例：周细胞（血管周细胞）肿瘤...........................133

第9章　骨骼肌肿瘤.............................................148
9.1　横纹肌肉瘤...............................................148
9.2　示例：骨骼肌肿瘤.........................................149

第10章　脉管肿瘤..............................................156
10.1　血管瘤..................................................156
10.2　血管瘤病................................................157
10.3　淋巴管瘤................................................157
10.4　卡波西样血管内皮瘤......................................158
10.5　网状血管内皮瘤..........................................158
10.6　Kaposi肉瘤..............................................158
10.7　上皮样血管内皮瘤........................................159
10.8　软组织血管肉瘤..........................................159
10.9　示例：脉管肿瘤..........................................160

第11章　软骨-骨肿瘤...........................................184
11.1　软组织软骨瘤............................................184
11.2　骨外骨肉瘤..............................................184
11.3　示例：软骨-骨肿瘤.......................................185

第12章　神经鞘膜肿瘤...........................................192
12.1　施旺细胞瘤（包括不同亚型）...............................192
12.2　神经纤维瘤（包括不同亚型）...............................193
12.3　神经束膜瘤...............................................194
12.4　颗粒细胞瘤...............................................194
12.5　恶性周围神经鞘膜瘤.......................................195
12.6　示例：神经鞘膜肿瘤.......................................196

第13章　分化不确定的肿瘤.......................................221
13.1　肌内黏液瘤...............................................221
13.2　滑膜肉瘤.................................................222
13.3　磷酸盐尿性间叶性肿瘤.....................................222
13.4　上皮样肉瘤...............................................223
13.5　腺泡状软组织肉瘤.........................................224
13.6　透明细胞肉瘤.............................................224
13.7　骨外黏液样软骨肉瘤.......................................225
13.8　骨外尤文肉瘤.............................................225
13.9　肾外恶性横纹肌样瘤.......................................226
13.10　肌上皮瘤/副脊索瘤.......................................226
13.11　多形性玻璃样变血管扩张性肿瘤............................226
13.12　示例：分化不确定的肿瘤..................................227

第14章　未分化/未分类肉瘤.......................................255
14.1　未分化多形性肉瘤..........................................255
14.2　未分化的圆形细胞和梭形细胞肉瘤............................256
14.3　示例：未分化/未分类肉瘤...................................256

第15章　浅表软组织肿块..........................................264
15.1　表皮包涵体囊肿............................................264
15.2　毛母质瘤..................................................264
15.3　脂肪坏死..................................................265
15.4　类风湿结节................................................266
15.5　Morel-Lavallee病变........................................266
15.6　恶性黑色素瘤..............................................267
15.7　淋巴瘤（皮肤及皮下）......................................267
15.8　软组织转移瘤..............................................269
15.9　示例：浅表软组织肿块......................................270

第16章　类似软组织肿瘤的肿块....................................292
16.1　腱鞘囊肿..................................................292
16.2　血管病变..................................................292
16.3　痛风......................................................293
16.4　结节病....................................................293
16.5　Morton神经瘤..............................................294
16.6　创伤性神经瘤..............................................295
16.7　黄色瘤....................................................295
16.8　示例：类似软组织肿瘤的肿块................................296

第三部分　软组织肿瘤实用诊断精粹
第17章　基于MR信号强度的病变特征................................316
17.1　T1WI高信号病变............................................318
17.2　T2WI低信号病变............................................322
17.3　T2WI液体样高信号病变......................................333

第18章　诊断征象................................................339
18.1　葡萄碗征..................................................339
18.2　葡萄串征..................................................340
18.3　棋盘征....................................................341
18.4　同轴电缆征................................................342
18.5　暗星征....................................................343
18.6　束状征....................................................344
18.7　倒靶征（Inverted target sign）............................345
18.8　脑回征....................................................346
18.9　反靶征（Reverse target sign）.............................347
18.10　反向分区现象.............................................348
18.11　意大利面征...............................................349
18.12　脂肪分离征.............................................. 350
18.13　串征.....................................................351
18.14　条纹征...................................................352
18.15　瑞士奶酪征...............................................352
18.16　尾征.....................................................354
18.17　靶征.....................................................355
18.18　三条纹征................................................ 356
18.19　三重信号征...............................................357
18.20　分区现象.................................................358

第19章　软组织肿瘤相关的综合征...................................359
19.1　Kasabach-Merritt综合征.....................................360
19.2　Maffucci综合征.............................................362
19.3　Klippel-Trenaunay综合征....................................364
19.4　Mazabraud综合征............................................365
19.5　神经纤维瘤病1型............................................366
19.6　神经纤维瘤病2型............................................370
19.7　神经鞘瘤病.................................................373
19.8　Carney综合征...............................................374
19.9　家族性高胆固醇血症.........................................376

第四部分　练习与实践
第20章　影像判读会话.............................................380
20.1　测验1......................................................380
20.2　测验2......................................................382
20.3　测验3......................................................384
20.4　测验4......................................................386
20.5　测验5......................................................388
20.6　测验6......................................................390
20.7　测验7......................................................392
20.8　测验8......................................................394
20.9　测验9......................................................396
20.10　测验10....................................................398
20.11　测验11....................................................400
20.12　测验12....................................................402
20.13　测验13....................................................404
20.14　测验14....................................................406
20.15　测验15....................................................408
20.16　测验16....................................................410
20.17　测验17....................................................412
20.18　测验18....................................................414
20.19　测验19....................................................416
20.20　测验20....................................................418
20.21　测验21....................................................420
20.22　测验22....................................................422
20.23　测验23....................................................424
20.24　测验24....................................................426
20.25　测验25....................................................428
20.26　测验26....................................................430
20.27　测验27....................................................432
20.28　测验28....................................................434
20.29　测验29....................................................436
20.30　测验30....................................................438
20.31　测验31....................................................440
20.32　测验32....................................................442
20.33　测验33....................................................444

附录.............................................................446