软组织侵袭性纤维瘤病的影像表现及其病理对照分析

目的分析侵袭性纤维瘤病(AF)的CT及MRI影像学特点及与病理的关系,提高对该病的认识和诊断水平。材料与方法回顾性分析14例经手术病理证实的AF(12例原发,2例复发)的临床资料和影像表现,并与术后病理进行对照分析。结果 CT平扫,4例病灶呈稍高密度,8例呈等密度,2例呈稍低密度;边界清晰3例,模糊9例;增强病灶均呈明显强化,未见包膜。MRI 检查,4例病灶局限于单一肌肉,10 例累及多块肌肉;3例肿瘤境界清楚、有不完整包膜,11例境界不清、无包膜、边缘呈爪状生长;与肌肉比较,病灶平扫T1WI呈等信号4例、呈低信号10例,T2WI均呈高信号;增强检查病灶呈明显不均匀强化。结论 MRI信号的差异主要反映了病灶的组织学成分的不同,MRI 比CT更精确地显示病灶的形态、范围及其与周围结构关系。

Imaging features of soft tissue aggressive fibromatosis with pathologic correlation

Objective： To discuss CT and MRI imaging features of aggressive flbromatosis （AF）, especially the characteristic signs of MRI, and to evaluate the value of diagnosis. Materials and Methods： The CT and MRI studies in 14 cases with pathologically proven AF were retrospectively analyzed. Results： Among 14 cases with AF, one cases could not be discovered by CT and all cases could be discovered by MRI. Appearances of lesion were infiltrating in 11 cases and mass-like in 3 cases. All cases were without calcification and lipo-tissue in the lesion and without edema on adjacent muscle structures. High density, equidensite or low density were seen on CT plain scans and high density on contrast enhanced scans. On MRI scans, equidensite or low signal intensity were demonstrated on T1WI, and high signal intensity on T2WI, as well as increased signal intensity after contrast enhancement. The signal characteristics primarily reflected the underlying histologic composition of the lesions. Conclusions： MRI is more excellent than CT in delineating the site, shape, and extent of these lesions. MRI is valuable in detecting and differentiating AF.