韧带样型纤维瘤病的影像学表现  

CT and MRI features of desmoid-type fibromatosis

作　　者：付芳芳[1] 史大鹏[1] 陈翠云[1] 刘冬[2] 沈海林[2] 

机构地区：[1]河南省人民医院放射科,河南郑州450003 [2]苏州大学第一附属医院影像科

出　　处：《实用放射学杂志》2012年第10期1591-1594,共4页Journal of Practical Radiology

摘　　要：目的探讨韧带样型纤维瘤病（desmoids—typefibromatosis，DF）的多层螺旋CT（MSCT）和MRI表现，以期提高对该病的认识。方法回顾性分析经手术病理证实的13例DF患者的临床及影像资料。结果13例DF中腹外型9例，腹壁型4例。肿块最大径平均为8．8cm（范围1．8～15．0cm），呈椭圆形或不规则形，无包膜，边界与周围组织分界不清，瘤内囊变、出血、坏死少见，均未见灶周水肿。6例行CT平扫和增强检查，平扫示肿块密度均匀，与肌肉密度相近，增强后呈轻、中度强化。8例行MRI平扫，之后其中6例行增强扫描，平扫示T1WI序列6例呈等信号，2例呈稍高信号，T2WI及STIR序列均呈高信号，信号不均匀，其内均可见斑点状或条带状低信号区，其中5例肿块内可见流空血管影；增强后病灶呈明显不均匀强化。结论DF是一种罕见的软组织肿瘤，其MSCT、MRI表现具有一定特征性，可为临床诊断提供客观依据，但确诊依赖病理。Objective To review MSCT and MRI findings of desmoid-type fibromatosis （DF）. Methods The clinic data, and MSCT and MRI findings of 13 pathologically proved cases of DF were retrospectively analyzed. Results Lesions were in extra ab- dominal location in 9 cases, and in abdominal wall muscles in 4 cases. The average size was 8.8 cm （range, 1.8--15.0 cm）, oval or irregular, with no capsule or clear boundary. There were few cystic, hemorrhagic and necrotic areas within the tumors, and there was no peri-lesion edema. Plain and contrast-enhanced CT was performed before operation in 6 cases. The masses were homogene- ous and of similar densities to the muscles on CT plain scan, and showed mild or moderate enhancement. 8 patients underwent MR examination （6 of which contrast-enhancement）. The masses showed iso-intensity in 6 cases and mild hypevintensity in 2 cases on T1WI, and hyper-intensity in all 8 cases on T2WI or STIR images. Spots or linear areas of low signal intensity were detected within tumors on all the MR images. Vascular flow void phenomenon was seen in 5 cases. All lesions showed intense enhancement on con- trast-enhanced MR. Conclusion DF is a rare soft tissue tumor, and is often clinically misdiagnosed. MSCT and MRI show certain imaging features, and could provide an objective basis for clinical diagnosis.

关 键 词：韧带样型纤维瘤病 计算机体层成像 磁共振成像 

分 类 号：R738.6[医药卫生—肿瘤] R814.42[医药卫生—临床医学]