目的 探讨胸膜-肺滑膜肉瘤 的影像学表现，提高对该病的诊断能 力。方法 回顾性分析6例胸膜-肺滑膜 肉瘤的临床、影像及病理资料，6例均 行X线检查、5例行CT检查、2例行MRI 检查。结果 X线示肺部均见较大或巨 大的占位，范围约 3 c m× 3 c m× 1 . 5 c m -15.3cm×22.5cm×16.9cm。CT示肿瘤均 为周围型，部分边缘光整，密度不均，内 未见钙化，增强后5例均呈明显不均匀强 化，3例侵及邻近叶间裂或胸膜。CT均未 见肺门及纵隔淋巴结肿大； MRI示T1WI呈 稍低信号，T2WI呈稍高信号，增强后肿块 轻度不均匀强化。术后病理示淋巴结均未 见肿瘤转移。免疫组织化学结果显示波形 蛋白(Vim)、细胞角蛋白(CK)、上皮膜抗 原(EMA)阳性。结论 胸膜-肺原发性滑膜 肉瘤的影像表现具有相对特征性表现，了 解影像学表现有助于临床手术方案的制定 及预后指导，确诊需要依靠病理及免疫组 化。

Objective To evaluate the imaging characteristics of PPSS (Pleuropulmonary synovial sarcoma, PPSS) and improve its diagnosis. Methods The clinical, imaging and pathology findings of 6 patients were retrospectively analyzed．All 6 patients received X-ray and 5cases had CT scan, 2 cases had MRI. Results Enormous mass in lungs were found in X-ray and their scope were 3cm×3cm×1.5cm to 15.3cm×22.5 cm×16.9cm. Peripheral tumors which showed clear margin partly will inhomogeneous density, was found in CT scan, and no calcification in the lesion. On the contrast-enhanced CT scan, 5 cases were inhomogeneous enhancement. Pleural or interlobar fissure invasion were detected in 3 patients. No llilar or mediastinal lymph nodes metastasis were seen in all cases. MRI showed T1WI were slightly low signal, T2WI were slightly high signal, the mass had mild heterogeneous enhancement．Lymph node metastasis was not found in pathologic. The immunohistochemical examinations of Vim, CK and EMA were positive in 6 patients. Conclusion There are some relatively specific imaging findings of primary pulmonary synovialsarcoma. Understand imaging findings will help clinical surgery and prognosis guidance, accurate diagnosis depends on pathology and immunohistochemistry.