脂肪肉瘤CT及MRI的影像特征与病理分型的对照分析

目的分析不同病理分型的脂肪肉瘤(liposarcoma,LPS)在CT及MRI的特征性表现。方法回顾性分析32例本院经病理证实的脂肪肉瘤患者的CT、MRI影像学表现,从而分析脂肪肉瘤不同病理类型的CT、MRI特点。结果32例脂肪肉瘤患者中,分化良好型10例、黏液型(含圆细胞脂肪肉瘤)6例、去分化型7例、多形性5例、混合型4例。分化良好型脂肪肉瘤以脂肪密度或信号为主;黏液型脂肪肉瘤单囊性稍低密度或信号为主;去分化脂肪肉瘤结节密度或信号不均匀,多结节病变内结节之间分界清楚,可见出血或钙化;多形性脂肪肉瘤密度及信号不均匀,肿瘤边界不规则,无明显包膜;混合型脂肪肉瘤表现为多发大小不等结节,各结节的密度或信号及强化方式均不相同。结论不同病理分型的脂肪肉瘤在CT、MRI均有一定的特征性表现,可以为脂肪肉瘤的准确诊断、手术方案的制订及预后的评估提供有力的证据。

Comparative analysis of CT and MRI imaging features and pathological classification of liposarcoma

Objective To analyze the CT and MRI features of different pathological types of liposarcoma(LPS).Methods CT and MRI imaging findings of 32 patients with liposarcoma confirmed by pathology in our hospital were retrospectively analyzed,so as to analyze the CT and MRI characteristics of different pathological types of liposarcoma.Results Among the 32 patients with liposarcoma,there were 10 cases of well-differentiated type,6 cases of mucous type(including round cell liposarcoma),7 cases of dedifferentiated type,5 cases of pleomorphism,and 4 cases of mixed type.The well-differentiated liposarcoma mass with clear margins was predominantly characterized by fat density or signal.Myxoid liposarcoma was characterized by a slightly low density or signal intensity.Dedifferentiated liposarcoma nodules was not uniform,the demarcation between nodules in multi-nodule lesions was clear,and the hemorrhage or calcification can be found.Pleomorphic liposarcoma can be found uneven density or signal,irregular border.Mixed liposarcoma manifested as multiple nodules of different sizes,and the density or signal intensity and enhancement mode of each nodule were different.Conclusion Liposarcoma of different pathological types has certain characteristic manifestations on CT and MRI,which can provide strong evidence for the accurate diagnosis of liposarcoma,the formulation of surgical procedures and the evaluation of prognosis.