手术前后复发腹部外侵袭性纤维瘤病影像学观察  

ICONOGRAPHIC OBSERVATION OF AGGRESSIVE FIBROMATOSIS LOCATING OTHER THAN ABDOMEN:BEFORE SURGERY AND POSTOPERATIVE RECURRENCE

作　　者：马千里[1] 蒋钢[1] 刘士锋[1] 刘学军[1] 李晓莉[1] 冯卫华[1] 

机构地区：[1]青岛大学医学院附属医院放射科,山东青岛266003

出　　处：《齐鲁医学杂志》2013年第5期425-428,共4页Medical Journal of Qilu

摘　　要：目的分析腹部外侵袭性纤维瘤病(eAAF)影像学表现,对临床治疗及预后作出评估。方法回顾性分析首诊并经病理证实11例eAAF病人的术前CT、MR表现,并与术后复发病例的影像学表现进行对比。结果本组11例eAAF中,3例发生于颈肩部及腋窝,2例发生于上肢,6例发生于下肢及髋周。肿瘤多呈圆形、卵圆形或不规则形,浸润性生长。术前CT图像,病灶相对于骨骼肌呈均匀略低密度,2例增强扫描呈轻度渐进式均匀强化。术前8例行MR检查,T1WI呈类似肌肉样低信号,压脂像或STIR呈明显高信号,脂肪抑制序列中均可见不规则斑点状、蚓状低信号影。4例行MR增强检查显示,病变主体呈明显不均匀强化,MR平扫短T2信号影未见强化。术后随访6例均复发,病变体积明显大于术前,密度或信号均较术前不均匀,脂肪抑制序列T2WI中短T2低信号影体积较术前增大。结论 eAAF具有较特征性影像学表现,CT、MRI检查能够提高术前诊断的准确率。eAAF局部外科切除术后复发率高,且复发病例的影像学表现更具侵袭性。Objective To analyze iconographic manifestations of aggressive fibromatosis （AF） locating other than abdo- men, and assess its treatment and prognosis. Methods A retrospective analysis of preoperative CT and MR findings in 11 cases of AF was done, and compared with that of recurrent cases. Results Of the 11 cases, three located in neck and shoulder and axilla, two in upper limbs, six in lower limbs and hip joint region. Tumors mostly presented as roundness or oval or irregular, with infiltrative growth. Preoperative CT showed homogeneous hypointensity in the lesions as compared with skeletal muscle, and mild homogeneous enhancement was seen in two cases with enhancement scanning. MR was done in eight cases before surgery, T1 weighted images showed hypointensity similar to that of muscle, hyper-intensity in fat suppress fast spin echo T2-weighted images （FS FSE T2WI） or short time inversion recovery （STIR）. All cases showed spotted or curving low signal on fatty restraint scan. Lesions in four cases were highly heterogeneous enhanced after intravenous gadolinium on fat suppress spin echo T1WI （FS FSE T1WI）, and areas showing short T2 signal were not enhanced. Postoperative recurrence was recorded in six cases, the size of tumors was bigger than that before surgery, the intensity or signal was more uneven than before surgery, low signal on fatty re- straint scan was bigger than before. Conclusion AF has more specific imaging manifestations, CT and MRI can raise the accura- cy of preoperative diagnosis of this condition. High recurrence rate is attributed to local resection. The iconographic appearances of the recurrent cases suggest of more invasive.

关 键 词：纤维瘤病 侵袭型 复发 体层摄影术 x线计算机 磁共振成像 

分 类 号：R730.44[医药卫生—肿瘤]