胸部腹外型侵袭性纤维瘤病的CT表现

目的：分析发生于胸部的腹外型侵袭性纤维瘤病的CT表现，提高对本病的诊断水平。方法：回顾性分析19例经手术病理证实的胸部侵袭性纤维瘤病患者的CT 表现。19例均行 CT 平扫，9例行增强扫描，1例行 CTA 检查。结果：19例共检出23个病灶，其中3例为多发病灶（发生于软组织1例、骨骼2例）。病变位于软组织15例共16个病灶（两侧和前胸壁8个、背部5个、肩部1个、腋窝1个），位于骨骼4例共7个病灶（肋骨5个、胸肋关节1个、胸骨上段1个）。16个软组织肿块中呈类圆形或梭形13个，分叶形或不规则形3个；边界不清13个，边界清晰3个（其中2个有假包膜）；CT平扫表现为等或低密度肿块14个，囊实性肿块2个，3个病灶内可见钙化（分别呈点状、弧形和爆米花样）；增强扫描9例共10个病灶中，表现为轻度均匀强化2个，明显不均匀强化2个，边缘轻度强化1个，边缘明显强化2个，轻中度不均匀强化2个，多发小圆形轻中度环形强化1个；5个病灶可见肿瘤与骨质粘连伴骨质破坏。4例共7个骨骼病灶，CT 平扫6个表现为骨内软组织肿块、膨胀性骨质破坏（1个出现周缘硬化边），1个表现为软组织肿块伴有局限性骨皮质压迫吸收；肿块呈较低密度3个，等或稍低密度3个，稍高密度1个；1例行增强扫描，肿瘤呈轻度～中度不均匀强化。结论：胸部侵袭性纤维瘤病的CT表现有一定特征性，CT对本病具有较高的诊断价值。

CT features of extra-abdominal aggressive fibromatosis of the thorax

Objective:To analyze the CT findings of extra-abdominal aggressive fibromatosis of the thorax,and to im-prove the diagnostic accuracy.Methods:CT images of 1 9 patients with extra-abdominal aggressive fibromatosis of thorax proved by surgery and pathology were analyzed retrospectively.All the patients had pre-contrast CT images,and 10 cases had enhanced CT images including one with CTA data.Results:23 lesions were found in the 19 patients,among which 3 ca-ses had multiple lesions (1 case in soft tissue of chest,2 cases in bone of chest).1 6 lesions of 1 5 cases were originated from soft tissue,including anterior and bilateral chest wall (n= 8),back (n= 5),shoulder (n= 1)and armpit (n= 1);and 7 le-sions of 4 cases were originated from bone,including rib (n= 5),sternocostal joint (n= 1)and upper sternum (n= 1).The 1 6 soft tissue tumors presented as oval or spindle shape (n= 1 3 )or irregular shape (n= 3 ),with well-defined margin (n=3),and pseudocapsule in 2 of the 3 lesions or ill-defined margin (n= 13).On pre-contrast CT images,there were solid mass with hypo- or isodensity (n= 14)or cystic and solid mass (n= 2)on pre-contrast CT images,and calcification was observed in 3 lesions.On contrast enhanced CT images of 10 lesions,mild homogeneous enhancement (n= 2),significantly heteroge-neous enhancement (n= 2 ),mild peripheral enhancement (n= 1 ),significantly peripheral enhancement (n= 2 ),mild to moderate heterogeneous enhancement (n= 2),and mild to moderate multiple circular enhancement (n= 1)were found.Bone destruction could be seen in 5 lesions (5/1 6 ).Of 7 lesions located in bone,six showed masses with soft tissue density and expansive destruction of bone (with sclerotic rim in one case),and one showed soft tissue mass with compressive change of adjacent bone;the masses were hypodense in 3 cases,iso- or mildly hypodense in 3 case,and mildly hyperdense in one case. Conclusion:Extra-abdominal aggressive fibromatosis of thorax has certain characteristics on CT,and CT can be a valuable examination for the diagnosis.