骨原发性恶性纤维组织细胞瘤的影像学诊断及鉴别诊断（附9例报告分析）

目的 研究骨原发性恶性纤维组织细胞瘤的影像学表现及诊断要点．方法 回顾性分析9例经手术和病理证实的骨原发性恶性纤维组织细胞瘤的X线、CT及MR的影像学特征及临床资料．结果 原发性骨恶性纤维组织细胞瘤好发于长骨干骺端或骨端，多见于股骨下端及胫骨上端，影像学表现呈多种多样，为溶骨性骨质破坏，并伴有明显软组织肿决，骨膜反应少见．本组3例位于股骨下端，3例胫骨上端，1例位于肋骨，下颌骨1例．1例为多骨多发．结论 骨原发性恶性纤维组织细胞瘤影像学表现及临床特征缺乏特异性．若在长骨或其它骨出现溶骨性骨质破坏，并伴有巨大软组织肿块，无骨膜反应，应考虑诊断骨原发性恶性纤维组织细胞瘤的可能．确诊仍须手术及病理检查．

The imaging diagnosis and differential diagnosis of malignant fibrous histiocytoma of bone (a report of 9 cases)

Objective To study the imaging findings and diagnostic value of primary malignant fibrous histiocytoma of bone(PBMFH).Methods The X-ray and CT data and MR imaging findings and clinical data of 9 cases with primary malignant fibrous histiocytoma of bone confirmed by operation and pathology were reviewed retrospectively.Results Most of the PBMFH arose in the metaphysic or the ends of long bone.The distal femur or prosimal humerus are the most frequently involved.All the imaging findings of malignant bone tumors were revealed.The imaging appeared as osteolytic bone destruction change and soft tissue mass.It is rare for periosteal reaction. The lesions involved single bone in 8 cases and multiple bones in 1 case.The distal femur was seen in 3 cases,prosimal humerus in 3 cases,rib in 1 case,mandible in 1 case and multiple bone was showed in 1 case.Conclusion The CT of PBMFH usually did not show characteristic findings.The diagnosis of PBMFH should be take into consideration if the osteolytic bone destruction arise in long bone with large soft tissue mass and no for periosteal reavtion.The confirmed diagnosis of PBMFH must be depended on the operation and pathology.