原发性骨恶性纤维组织细胞瘤的影像学分析  

Clinical and Imaging Analysis of Primary Malignant Fibrous Histiocytoma of Bone

作　　者：陈平有[1] 杜恩甫[1] 李丹[2] 仇俊华[1] 母华国[1] 

机构地区：[1]郧阳医学院太和医院放射科,湖北442000 [2]郧阳医学院太和医院病理科,湖北442000

出　　处：《放射学实践》2009年第12期1341-1344,共4页Radiologic Practice

摘　　要：目的:探讨原发性骨恶性纤维组织细胞瘤(BMFH)的临床及影像学特点。方法:回顾性分析经手术病理证实的13例原发性BMFH的临床及X线片、CT、MRI表现,总结不同影像学检查方法的应用价值。结果:13例中,男8例,女5例,40岁以上10例;长骨骨端11例,长骨骨干1例,髂骨1例。13例X线和CT表现为溶骨性骨质破坏,其中6例病灶边缘有轻度骨硬化,7例骨质破坏区间夹杂粗细不等的骨嵴,骨膜反应1例。全部病例均见超过骨破坏范围的软组织肿块。MRI表现为T1WI等-低信号,T2WI以等信号为主,间有片状短T2和长T2信号,增强扫描病变不均匀强化。结论:原发性BMFH以中老年男性多见,好发于长骨骨端。X线平片为首诊方法,CT和MRI对显示病灶范围及病变细微结构价值大。骨破坏区内粗大骨嵴、超过骨破坏范围的软组织肿块及骨膜反应少见是原发性BMFH的影像特点,有助于诊断与鉴别诊断。Objective：To evaluate the clinical and imaging characters of primary malignant fibrous histiocytoma of bone（BMFH）.Methods：The clinical data,and plain film,CT and MRI findings of 13 patients with primary BMFH confirmed surgically and pathologically were retrospectively analyzed,and the applied values of these different imaging methods were summarized.Results：Of the 13 patients,8 were men and 5 were women with the ages above 40 years old in 10 cases.The tumors were located in ends of long bone in 11 cases,diaphysis in 1 case,and ilium in 1 case.The common imaging appearances on the plain film and CT were osteolytic bone destructions,of which 6 cases had sclerotic margins,7 cases had various bony at destruction,and 1 case had periosteal reaction.The extraosseous soft tissue masses were observed in all cases.MRI showed iso-hypointensity on T1-weighted image and heterogeneous signal on T2-weighted image,and heterogeneous enhancement was found within the lesions.Conclusion：The primary BMFH usually involved middle-old men,and the ends of long bone are the most frequently involved.Plain film is the first choice and taken as essential means of diagnosis.CT and MRI are very helpful in showing the extent and details of the disease but not specific.The imaging character of primary BMFH is osteolytic bone destructions with various bony crest and a large soft tissue mass but without remarkable periosteal reaction.

关 键 词：骨肿瘤 恶性纤维组织细胞瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738[医药卫生—肿瘤]