软组织黏液纤维肉瘤的超声表现

目的探讨软组织黏液纤维肉瘤(MFS)的超声表现。方法回顾性分析经病理学证实的12例软组织MFS超声表现,并对不同组织病理学级别病灶进行比较。结果12例MFS患者的中位年龄为51岁,其中11例(11/12,91.67%)为男性;8例(8/12,66.67%)高级别MFS,4例中低级别MFS;8例(8/12,66.67%)发生于四肢,4例(4/12,33.33%)发生于躯干;6例(6/12,50.00%)单发;7例(7/12,58.33%)出现术后原位复发。超声表现:均为实性弱回声团块,其中10例(10/12,83.33%)位于皮下层,2例(2/12,16.67%)位于肌层;肿瘤最大径约(34.08±21.90)mm;9例(9/12,75.00%)边界不清楚、形态不规则;11例(11/12,91.67%)内部回声不均匀。1例高级别MFS出现局部淋巴结转移。CDFI显示8例(8/12,66.67%)为0~1级血流,4例(4/12,33.33%)2~3级血流。高级别与中低级别组比较:边界、形态的差异均有统计学意义(P均0.05),而病灶位置、病变大小、淋巴结转移、有无复发、病变数目、内部回声、有无坏死及血流分级上的差异均无统计学意义(P均0.05)。结论 MFS的超声图像均表现为实性弱回声病灶,多数边界不清楚,形态不规则,内部回声不均匀。高级别MFS多表现为边界不清楚、形态不规则。

Ultrasonic manifestations of soft tissue myxofibrosarcoma

Objective To observe the ultrasonic manifestations of soft tissue myxofibrosarcoma (MFS). Methods The ultrasonic manifestations of 12 pathologically confirmed MFS were analyzed retrospectively, and the lesions with different histopathological feature were compared. Results The median age of 12 cases was 51 years old, consisted of 11 males (11/12, 91.67%); 8 cases (8/12, 66.67%) were high-grade MFS and 4 low and medium-grade; 8 cases (8/12, 66.67%) occurred in limb and 4 cases (4/12, 33.33%) in trunk; 6 cases (6/12, 50.00%) were solitary and 7 cases (7/12, 58.33%) recurred. Ultrasonographically, all lesions had hypoechoic pattern; 10 cases (10/12, 83.33%) were located in subcutaneous layer and 2 cases (2/12, 16.67%) in muscular layer, size ranging (34.08±21.90) mm, 9 cases (9/12, 75.00%) show irregular shape and unclear border, 11 cases (11/12, 91.67%) shows heterogeneous pattern. And 1 high-grade MFS occurred regional lymph node metastasis. CDFI showed, 8 lesions (8/12, 66.67%) were grouped into grade 0-1, 4 cases (4/12, 33.33%) into grade 2-3. Comparing high grade and low-intermediate grade MFS, the difference of border and shape were statistically significant (both P<0.05). While the location, size, lymphatic metastasis, recurrence, quantity, inner echo, necrosis and blood flow were with no significant difference (all P>0.05). Conclusion Ultrasonic images of MFS all show solid and hypoechoic lesions, most with blurry boundary, irregular shape, heterogeneous internal echo. Especially high-grade MFS most likely shows blurry boundary and irregular shape.