肢体软组织侵袭性纤维瘤病组织病理特征的MRI研究  

MRI evaluation of the histopathological characteristic of limb soft-tissue aggressive fibromatosis

作　　者：江波[1] 杨献峰[1] 赖英荣[2] 潘碧涛[1] 单卉[1] 陈应明[1] 孟悛非[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080 [2]中山大学附属第一医院病理科,广州510080

出　　处：《中华放射学杂志》2009年第2期141-145,共5页Chinese Journal of Radiology

摘　　要：目的探讨应用MRI评估肢体软组织侵袭性纤维瘤病（AF）组织病理特征的意义。方法分析20例AF的MRI和组织病理学表现；比较AF瘤内不同MRI信号区的T1WI、T2WI信号及强化程度，观察瘤内不同MRI信号区的HE染色与Masson三色染色表现。对所获数据进行配对t检验。结果（1）AF起源于骨骼肌（19／20），边缘分叶（20／20），呈浸润性生长（20／20）；（2）三维动态对比增强血管造影（3D—DCEMRA）显示瘤体边缘少量爪状新生动脉（7／7）和轻度肿瘤染色（7／7）；（3）根据MRI表现，20例AF分为Ⅰ区、Ⅱ区2种结构。Ⅰ区，在T1WI、T2WI上为极低信号，增强扫描不强化；Ⅱ区，T1WI上呈等信号或稍高信号，T2WI上呈稍高信号，增强后显著强化；（4）Ⅰ区的T1WI、T2WI信号及强化程度分别为（0．10±0．02）、（0．24±0．03）和（5．22±0．42）％，Ⅱ区依次分别为（0．79±0．04）、（3．05±0．08）和（151．5±8．61）％，两者的T1WI信号（t=67．37）、T2WI信号（t=196．56）及强化程度之间（t=76．62）的差异均有统计学意义（P值均〈0．01）；（5）AF由成纤维细胞、纤维细胞和胶原纤维束组成。Masson三色染色上，Ⅰ区呈蓝色，为成熟的胶原纤维束；Ⅱ区不染色，主要成分为成纤维细胞与纤维细胞。结论AF的Ⅰ区、Ⅱ区结构在MRI上有明显特征，MRI能准确反映AF的组织病理与生物学行为特征。Objective To assess the value of using MRI to evaluate the histopathological characteristic of limb soft-tissue aggressive fibromatosis （AF）. Methods The MRI findings and histopathological data of 20 patients with AF were obtained and analyzed. The difference between the different signal regions in AF were compared of signal intensity in T1-weighted images, T2-weighted images and degree of enhancement. The data were processed with paired t test. The histopathology of different signal regions was observed in 6 cases on HE stain and Masson trichromic stain of AF specimen. Results （ 1 ） AF predominantly originated from the skeletal muscles （19/20）, presenting as lobulated mass with infiltrative growth（20/20） ;（2） A few claw-shaped neo-arteries（7/7） were delineated in the periphery of the mass in the 3D DCEMRA images as well as the mild tumor staining（7/7） ; （3） Based on the MRI findings, the parenchyma of 20 AF was divided into two distinct regions of structure： region Ⅰ and region Ⅱ. Region Ⅰ presented as hypointensity on both T1-weighted and T2-weighted images and no enhancement after i. v. administration of contrast. Region Ⅱ presented as mild hyperintensity on T2-weighted images and isoor hypointensity on Ta-weighted images and marked enhancement; （4） The signal intensity in T1-weighted images, T2-weighted images and degree of enhancement was 0. 10 ± 0. 02,0. 24 ± 0. 03, and （5.22± 0.42）% in region Ⅰ , respectively; and 0.79 ±0.04,3.05 ±0.08 and（151.5 ±8.61）% in region Ⅱ , respectively. The differences between region Ⅰ and region Ⅱ were statistically significant of signal intensity in T1 -weighted images（ t = 67. 37 ）, and signal intensity in T2-weighted images（ t = 196.56） and degree of enhancement（t = 76. 62） （P 〈 0. 01 ） ; （5） Histologically, AF was composed of fibroblasts, fibrocytes and bundles of collagen fiber. On Masson trichromic stain, region Ⅰ was stained blue, being proven the mature collagen fibers. Region �

关 键 词：肌纤维瘤病 磁共振成像 病理学 

分 类 号：R686[医药卫生—骨科学]