Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Soft Tissue Metastasis in Patients with Primary Malignancies; Magnetic Resonance Imaging and Clinical Evaluations

원발암이 있는 환자에서 연조직 전이; 자기공명영상과 임상적 평가

  • Park, So Min (Department of Radiology, Pusan National University Hospital Biomedical Research Institute) ;
  • Lee, In Sook (Department of Radiology, Pusan National University Hospital Biomedical Research Institute) ;
  • Song, You Seon (Department of Radiology, Pusan National University Hospital Biomedical Research Institute) ;
  • Park, Shin Young (Department of Radiology, Pusan National University Hospital Biomedical Research Institute) ;
  • Lee, Hoseok (Department of Radiology, Kyungpook National University Hospital) ;
  • Yi, Jae Hyuck (Department of Radiology, Keimyung University, Dongsan Medical Center) ;
  • Song, Jong Woon (Department of Radiology, Inje University Haeundae Paik Hospital)
  • 박소민 (부산대학교병원 의생명연구원 영상의학과) ;
  • 이인숙 (부산대학교병원 의생명연구원 영상의학과) ;
  • 송유선 (부산대학교병원 의생명연구원 영상의학과) ;
  • 박신영 (부산대학교병원 의생명연구원 영상의학과) ;
  • 이호석 (경북대학교병원 영상의학과) ;
  • 이재혁 (계명대학교 동산의료원 영상의학과) ;
  • 송종운 (인제대학교 부산해운대백병원 영상의학과)
  • Received : 2017.06.23
  • Accepted : 2017.11.02
  • Published : 2018.05.01
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Abstract

Purpose: The purpose of this study was to evaluate the clinical and magnetic resonance imaging (MRI) findings of soft tissue metastases distinct from benign soft tissue lesions. Materials and Methods: We retrospectively analyzed the MRI findings of soft tissue lesions found incidentally in patients with primary carcinoma and those without primary carcinoma from 2002-2015. To evaluate the features of soft tissue metastases distinct from benign soft tissue lesions, patients with benign soft tissue lesions were randomly selected and statistically analyzed for the distinctive features of the two groups. Results: A total of 47 patients (mean age 46.2 years) and 36 controls (mean age 46.2 years) were enrolled. Thirty six of the 47 patients were diagnosed with soft tissue metastasis, most commonly as the primary cancer (31%). The most common site of soft tissue metastasis was the lower extremities (36%) followed by the upper extremities (31%). Soft tissue metastasis was statistically significantly different from benign soft tissue lesions according to patient age, lesion size, margin, presence of degenerative changes in lesions, and presence of edema around the mass. Conclusion: If the incident soft tissue lesion shows malignant features on MRI in patients with primary carcinoma or in patients over 40 years of age, the radiologist should consider the possibility of metastatic cancer.

목적: 본 연구는 양성 연조직 병변과 구분되는 연조직 전이의 임상 소견과 자기공명영상 소견을 찾고자 한다. 대상과 방법: 2002~2015년 동안 원발암이 있는 환자 및 원발암을 모르고 있던 환자에서 우연히 발견된 연조직 병변의 자기공명영상소견을 후향적으로 분석하였다. 양성 연조직 병변과 구분되는 연조직 전이의 특징을 평가하기 위해 같은 기간 내 진단된 양성 연조직 병변 대조군을 무작위로 선정하였고, 두 군의 구별되는 특징에 대해 통계학적으로 분석하였다. 결과: 총 47명(평균연령 60.7세)의 환자와 대조군 36명(평균연령 46.2세)을 본 연구에 포함하였다. 47명 중에 36명이 연조직 전이로 진단되었다. 전체 연조직 전이 중 원발암이 폐암인 경우가 가장 많았다(31%). 연조직 전이의 가장 흔한 위치는 하지(36%)였으며, 다음으로는 상지(31%)였다. 연조직 전이는 나이, 병변의 크기, 경계, 병변 내 퇴행성 변화의 유무, 종괴주위 부종의 유무에서 양성 연조직 병변과 통계학적으로 유의한 차이를 보였다. 결론: 원발암이 있거나 혹은 원발암의 존재를 모르고 있는 40세 이상의 환자에서, 우연히 발견된 연조직 병변이 자기공명영상에서 악성의 특징을 보일 때, 영상의학과 의사는 전이암의 가능성을 생각해야 한다.

Keywords

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