侵袭性纤维瘤病的MRI表现及其临床病理  

Clinical and MRI manifestations of aggressive fibromatosis and its pathological basis

作　　者：庄晓曌[1] 陈应明[2] 余深平[2] 马玲[2] 江波[2] 

机构地区：[1]海南省人民医院放射科,海口570311 [2]中山大学附属第一医院放射科

出　　处：《中华普通外科学文献（电子版）》2012年第2期27-29,共3页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的分析侵袭性纤维瘤病(AF)的临床、磁共振成像(MRI)表现及其病理,评价MRI在AF诊断及术前评估中的价值。方法回顾性分析25例经手术及病理检查证实的AF的临床及MRI表现,并与手术、病理结果对照分析。结果 25例AF呈类圆形、梭形改变,其中21例瘤体边界不清,无包膜,向周围浸润生长;4例见不完整假包膜。肿块在T1WI上以等及稍高信号为主,在T2WI上以高信号为主,信号低于脂肪组织,夹杂斑片状及条状低信号区;少数病例信号均匀(4/25)。增强扫描病变呈不均匀强化21例,均匀强化4例,侵犯肌肉、邻近脂肪组织、血管神经束和邻近骨分别为20例、13例、12例和5例。肿瘤由不同比例增生活跃的成纤维细胞、纤维细胞和胶原纤维束组成,细胞无异型性。结论 AF有特征性的临床、MRI表现,MRI对提高AF的正确诊断率及术前评估具有重要作用。Objective To analyze the clinical and MRI manifestations of aggressive fibromatosis （AF） and its pathological basis, and evaluate the value of MRI in the AF diagnosis and preoperative assessment. Methods Clinical and MRI appearances of 25 cases confirmed AF by pathology were retrospectively analyzed, and compared with findings of operation and pathology. Results Twenty-five cases of AF were round- or spindle-shaped, in which 21 cases had unclear boundary and no capsule, they also was infiltrative growing; the other 4 cases was observed that has incomplete pseudocapsule. Predominant iso- or slight high signal intensity on TIWI and high signal intensity on T2WI were revealed in tumors, of which signal lower than adipose tissue, and accompanied by speckle-shaped and strip- shaped areas of low signal intensity on both T1WI and T2WI within the tumors; Homogeneous signal intensity in a few cases was observed （4/25）. Heterogeneous enhancement was observed in 21 cases, and homogeneous enhancement in 4 cases. Invasion of muscle, fat tissue, blood-nerve bundle and erosion of bone were observed in 20, 13, 12, and 5 cases, respectively. Tumor was composed of different proportions of lively proliferative fibroblasts, fibrocytes and collagenons fiber bundles, with no atypia tumor cells was found. Conclusions There are characteristic clinical and MRI features in AF. MRI plays an important role to improve correct diagnosis rate and preoperative assessment of AF.

关 键 词：侵袭性纤维瘤病 软组织肿瘤 磁共振成像 病理学 

分 类 号：R730.4[医药卫生—肿瘤]