恶性纤维组织细胞瘤影像征象分析及诊断  

The analysis and imaging diagnosis of malignant fibrous histiocytoma

作　　者：曾俊杰[1] 田志雄[1] 张在鹏[1] 朱凌[1] 胡慧娟[1] 

机构地区：[1]武汉大学中南医院放射科,武汉430071

出　　处：《放射学实践》2011年第12期1290-1293,共4页Radiologic Practice

摘　　要：目的:探讨恶性纤维组织细胞瘤(MFH)的CT及MRI征象,提高对该病的诊断水平。方法:搜集15例经手术病理确诊的MFH影像学资料进行回顾性分析,其中12例行CT检查,4例行MRI检查,2例行CT与MRI检查。结果:6例瘤体位于四肢,类圆形,边界模糊;其中2例MRI表现为T1WI呈等或稍低信号,T2WI稍高混杂信号;其中2例在术后随访过程中原位复发。1例瘤体位于腰背部,边界模糊,邻近骨质可见破坏征象;T1WI呈等信号,T2WI呈高、稍高混杂信号。3例瘤体位于腹膜后,其中1例最大径约12cm,分叶状,CT增强实质部分中度强化。少见部位:左颞叶、上颌窦、肺部、肝脏、肾脏各1例,其中肝脏MFH术后复发并多处转移。结论:恶性纤维组织细胞瘤CT、MRI表现多样,位于四肢和腹膜后MFH影像表现具有一定鉴别特点,少见部位MFH影像鉴别复杂,最终靠病理确诊。Objective：To discuss the CT and MRI findings of malignant fibrous histiocytoma,and to improve its radiological diagnosis.Methods：A retrospective analysis was made of the imaging data of 15 pathologically confirmed cases of malignant fibrous histiocytoma,CT examination was done in 12 cases,MRI examination in 4 cases,both CT and MRI examination in 2 cases.Results：Six cases had lesions located in the limb muscles,the tumors were round in shape and unclear at the edges,in which 2 cases presented hypointensity and isointensity on T1WI,hyper-or mixed intensity on T2WI,and 2 cases had tumor recurrence at the original site.One case had lesion in the back,unclear at the edges,T1WI showed hypointensity and isointensity and T2WI showed hyper-or mixed intensity.Three cases had lesions located in the retroperitoneal space,the maximum diamaeter of the tumor was 12cm,the shape was multilobulated,enhanced scan showed a moderate peripheral enhancement.Five cases had lesions located in uncommon places：temporal lobe in 1 case,maxillary sinus in 1 case,lung in 1 case,kidney in 1 case and liver in 1 case.The tumor in liver had multiple retroperitoneal space metastases on follow-ups.Conclusion：The imaging findings of MFH located in the limb muscles and retroperitoneal space have certain characteristic manifestations.It is difficult for CT/MRI performance to differentiate those lesions located at uncommon sites,and the diagnosis needs the help of pathologic examinations.

关 键 词：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：R730.4[医药卫生—肿瘤]