四肢硬纤维瘤的MRI诊断  

MRI diagnosis of desmoid tumor in limbs

作　　者：李开成[1] 刘玉[1] 陶晓峰[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院放射科,上海200011

出　　处：《实用放射学杂志》2014年第2期271-274,共4页Journal of Practical Radiology

基　　金：上海市体育局科研攻关与科技服务课题（13JT022）;国家自然科学基金项目（81272802）;上海青年医师培养资助计划项目.

摘　　要：目的 探讨四肢硬纤维瘤（desmoid tumor,DT）的磁共振（magnetic resonance imaging,MRI）表现,提高对其诊断水平.方法 回顾性分析本院经手术病理证实的20例DT的临床及影像学资料.所有患者均行MRI平扫及增强扫描.2倪患者行动态MRI增强扫描和弥散加权成像（diffusion weighted imaging,DWI）.结果 20例患者共22个病灶,分别为腋窝5例;腘窝、小腿各4例;上肢、大腿各3例;臀部2例;肩锁部1例.14个病灶呈不规则形,8个病灶呈梭形.病灶最大径3.5～25 cm,平均9.7 cm.病灶在T1WI上以等信号或稍低信号为主,在T2 WI和脂肪抑制相上以不均匀高信号为主,增强后多数呈不均匀明显强化.2例患者动态增强上时间-信号曲线呈持续上升型,DWI上表现为高信号,表观弥散系数值为1.5×10-3 mm2/s和1.6×10-3 mm2/s.结论 MRI扫描能清楚显示DT的部位、大小及其与周围组织的关系,有一定的特征性,但表现无特异性,确诊仍需依赖病理检查.Objective To investigate the MRI manifestations of desmoid tumor （DT） in limbs and improve its diagnostic accuracy.Methods The imaging and clinical data of 20 DT cases proved by pathology were analyzed retrospectively.All cases have been performed contrast-enhancement MRI.And two cases also have performed dynamic contrast-enhanced MRI （DCE-MRI） and diffusion weighted imaging （DWI）.Results Twenty-two lesions were detected in 20 cases,DT located in the axilla in 5 cases,the poples in 4 cases,the crus in 4 cases,the upper limb in 3 cases,the thigh in 3 cases,the gluteal region in 2 cases,and the acromioclavicular joint in 1 case.14 lesions showed irregular shape,and 8 lesions showed fusiform.The lesions ranged in maximum diameter from 3.5 to 25 cm with a mean of 9.7 cm.The lesions showed isointensity on T1WI,and heterogeneous hyperintensity on T2WI and fat suppression imaging.Most of the lesions displayed marked heterogeneous enhancement.The rising type of the time-signal intensity curve on DCE-MRI,and hyperintensity on DWI were showed in the 2 cases.The apparent diffusion coefficient values were 1.5 × 10 3mm2/s and 1.6 × 10-3 mm2/s,respectively.Conclusion MRI can demonstrate the location,size and relationship with surrounding tissue of DT clearly.The characteristics of MRI findings are nonspecific.The final diagnosis relies on pathological examination.

关 键 词：四肢 硬纤维瘤 磁共振成像 

分 类 号：R739.96[医药卫生—肿瘤] R445.2[医药卫生—临床医学]