原发性骨恶性纤维组织细胞瘤的影像学分析  

Radiological features of primary malignant fibrous histiocytoma of bnone

作　　者：王峥[1] 夏增产[2] 原卫民[3] 皮桂红 孙蓉 

机构地区：[1]中国人民解放军第458医院放射科 [2]中国人民解放军广州军区空军后勤部医院 [3]济南军区青岛第一疗养院放射科 [4]广州军区空军第95100部队卫生队

出　　处：《医学影像学杂志》2011年第6期905-907,共3页Journal of Medical Imaging

摘　　要：目的:探讨原发性骨恶性纤维组织细胞瘤(BMFH)的影像学表现,以提高该病的诊断水平。方法:回顾性分析经病理证实的原发性骨恶性纤维组织细胞瘤21例患者的X线摄片、CT和MRI的影像学特征,探讨影像学的诊断价值。结果:21例中长骨BMFH 18例,扁骨或不规则骨BMFH 3例。X线平片均有不规则溶骨性骨质破坏,相邻骨皮质破坏,9例病灶边缘有轻度骨硬化,5例伴有膨胀性改变,14例骨质破坏区周围出现弥漫性软组织肿胀;CT表现为不规则、无结构溶骨性骨质破坏,局部被软组织密度肿块所替代,邻近骨皮质呈不规则虫噬样破坏,同样可以看到有软组织肿胀,5例病灶内部见少许残留致密骨嵴和骨质破坏边缘断续性硬化,另有4例肿块内可见单发或多发囊状低密度区,未见钙化及残留骨结构;MRI表现:8例骨质破坏区均呈不均匀长T1长T2异常信号,其中夹杂斑片状或囊状更长T1长T2信号,均有骨皮质破坏并突破皮质形成软组织肿块。结论:原发性BMFH的影像学表现有一定的特征,X线平片、CT和MRI的结合有助于诊断。Objective：To investigate radiological manifestations of primary malignant fibrous histiocytoma of bone（BMFH） so as to improve imaging diagnosis ability of disease.Methods：Conventional radiographs,CT and MRI manifestations of 21 patients with primary BMFH confirmed by operation and pathology were retrospective1 y analyzed.Results：Of the 21 patients,the tumors were located in long bones in 18 cases,and in flat bones or irregular bones in 3 cases.On plain X-ray,all patients showed irregularly osteolytic lesions and consecutive cortical plate were destroyed.Nine cases had osteosclerosis on the borderline of mass,Five patients had varied degrees of cortical expanision,and 14 had large soft tissue masses adjacent to the lesions.On CT scan,the erosive,permeative destructive nature of the lesion is well seen,along with any soft tissue extension.Five had internal or marginal crest within the lesion and marginal inconsecutive osteosclerosis.And 4 cases had solitary or multiple cystic attenuation areas within the masses without any calcifications and residual architecture.MRI of 8 patients showed inhomogeneous long T1 and long T2 abnormal intensity with soft tissue masses adjacent to the osteodestructions.Conclusion：The primary BMFH have certain imaging features on plain X-ray,CT and MRI,Combined utilization of plain X-ray,CT and MRI is helpful for diagnosis of the disease before operation.

关 键 词：骨恶性纤维组织细胞瘤 影像学 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] R814.42[医药卫生—临床医学]