摘要
目的：探讨软组织韧带样纤维瘤（Desoid-type fibromatosis，DF）的MRI表现及其诊断价值。方法：搜集16例经病理证实的DF病例，术前5例行MRI平扫，11例行MR平扫和增强扫描，分析其MRI各种征象出现几率、征象组合与诊断符合率的关系。结果：腹外型12例，其中发生在臀部3例，背部1例，四肢7例，下颌部1例；腹壁型4例，2例腹外型术后1年和2年6月复发。形态不规则形或分叶9例，类圆形或梭形7例；横截面积最大者12.3 cm×10.5 cm，最小者1.9 cm×2.3 cm；14例肿瘤长轴与肌纤维平行。肿瘤与周围结构分界清楚6例，分界不清10例。13例信号不均匀，3例信号均匀，其中T1WI以等信号为主5例、以稍高信号为主11例，T2WI、STIR均呈高、等混合信号，以高信号为主；肿块内各序列均见不规则分布的条状、带状低信号影。增强扫描病变呈明显不均匀强化，平扫所示条状、带状低信号影强化程度轻或无明显强化。结论：韧带样纤维瘤MRI特征性表现为明显不均匀强化，平扫所示条状、带状低信号影强化程度轻或无明显强化，肿瘤长轴与肌纤维平行是DF的特征性影像学表现，正确认识这些征象对DF的诊断及鉴别诊断具有重要的价值。
Abstract
Objective: To investigate the MRI features and clinical value of soft tissue desoid-type fibromatosis(DF). Methods: Sixteen cases DF confirmed by pathology were collected, 5 cases were received MRI pre-scanning, 11 cases were received MR pre- and post-contrast scanning. To analyze the probability of various features, their combination and the diagnostic coincidence rate. Results: Among 12 extra-abdominal types, 3 cases were in the hip, 1 case was in back, 7 cases were in limbs, 1 case was in submandibular. Abdominal wall type had 4 cases. Two cases of extra-abdominal type were recurred after 1 or 2.5 years. Nine cases were lobulated or irregular contours． Seven cases were round or fusiform. The maximum size was 12.3 cm×10.5 cm, the minimus size was 1.9 cm×2.3 cm. Fourteen cases of tumor with long axis parallel to the muscle fibers. Six cases with clear boundary. Ten cases of boundary were not well defined. Thirteen cases with heterogeneous signal, 3 cases with homogeneous signal and five cases of iso-intensity were on T1WI, eleven cases with mild hyper-intensity on T2WI. Iso- or hyperintense on T2WI and STIR. Each sequence were found in the mass shadow irregular distribution of linear areas of low signal. Enhanced scan were obvious uneven arterial enhancement. Linear areas of low signal in pre-scanning were light or no obvious enhancement. Conclusion: Each MRI sequence was found in the mass shadow irregular distribution of linear areas with nor or slight enhancement in low signal, and tumor with long axis parallel to the muscle fiber were characteristic features of DF. It was important to understanding correctly of these signs for the diagnosis and differential diagnosis of DF.
关键词
软组织肿瘤 /
纤维瘤 /
磁共振成像
Key words
Soft tissue neoplasms /
Fibroma /
Magnetic resonance imaging
梁俊生;曾仲刚;李扬彬;王青云;李秋雨;许团新.
韧带样纤维瘤的MRI表现及鉴别诊断[J]. 中国临床医学影像杂志. 2015, 26(7): 512-515
LIANG Jun-sheng;ZENG Zhong-gang;LI Yang-bin;WANG Qing-yun;LI Qiu-yu;XU Tuan-xin.
MRI features and differential diagnosis of desoid-type fibromatosis[J]. Journal of China Clinic Medical Imaging. 2015, 26(7): 512-515
中图分类号：
Ｒ730.262
R738.6
Ｒ445.2
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