结节性筋膜炎的影像学表现与病理所见(附1例报告并文献复习)

目的 提高对结节性筋膜炎的影像学表现及其与组织病理学相关性的认识。方法 报告1例经病理证实的结节性筋膜炎病例，并结合文献分析其X线，CT，MRI表现及其与病理学的相关性。结果 本例发生于上臂下段之深层肌间筋膜。X线显示肱骨下段外后缘不规则骨皮质缺损。XT除显示骨质改变外，还可见与周围组织密度相同的软组织肿块MRI显示TtWl上病变周边区呈稍高于肌肉信号、中央区不均匀低信号；TtWl病变周边稍高信号、中央区均匀高信号(明显高于脂肪信号)：病理所见符合黏液和细胞混合型筋膜炎。结论 本病为一良性病变，其MRI表现与组织病理学有相关性。应与纤维性骨皮质缺损、纤维肉瘤、恶性纤维组织细胞瘤、及韧带样纤维瘤相鉴别，

The correlation between imaging appearance and histopathology of nodular fasciitis: a case report and review of the literature

Objective To understand the correlation between imaging appearance and histopathology of nodular fasciitis.Methods A patient with histopathologically proved nodular fasciitis underwent X-ray,CT and MRI examinations.The correlation between varied imaging appearances and histopathology was analyzed and the recent literature was reviewed.Results The lesion of nodular fasciitis occurred in deep layer intemuscular fascia at the lower end of the left upper arm.X-ray examination showed an irregular cortical bone defect in xeno-posterior border of humeral lower end.CT scan also revealed the soft tissue mass shadow in which the density was similar to the circumferential construction,except the cortical bone change visible on X-ray.On T1WI, the peripheral area of the lesion was slightly higher signal than that of muscle but the central area was inhomogeneous hypointense,on T2WI,the peripheral area of the lesion was slightly higher signal but the central area was homogeneous hyperintense(obviously higher than fat).The histopathologic finding was corresponding to the mucoid and cellular mixed pattern of nodular fasciitis.Conclusion Nodular fasciitis is a benign lesion and its MRI appearances are correlated with histopathology.This disease should be differentiated from fibrous cortical bone defect,fibrosarcoma,malignant fibrous histiocytoma,and ligament-like fibroma.