骨与软组织恶性纤维组织细胞瘤的MRI表现  

MRI representations of malignant fibrous histiocytoma of bone and soft tissue

作　　者：胡军 胡凯 赵宇红 李培岭[2] 冀一帆 

机构地区：[1]河南省洛阳市第一人民医院放射科,河南洛阳471002 [2]河南省洛阳正骨医院影像中心,河南洛阳471002 [3]川北医学院附属医院放射科,四川南充637000

出　　处：《医学影像学杂志》2014年第7期1214-1216,1227,共4页Journal of Medical Imaging

摘　　要：目的探讨原发性骨与软组织恶性纤维组织细胞瘤的MRI表现。方法回顾性分析18例经手术病理及免疫组化证实的骨与软组织恶性纤维组织细胞瘤患者的临床、MRI及病理资料。其中10例原发于软组织,8例原发于骨骼。结果原发性软组织恶性纤维组织细胞瘤好发于深部软组织,其MRI表现为:T1WI多呈稍低信号或等信号,T2WI均呈混杂高信号,部分可见分隔征(6/10)、假包膜(4/10)及瘤周水肿(2/10),增强扫描肿瘤实性部分多明显强化;骨恶性纤维组织细胞瘤好发于长骨骨端,其MRI表现为:T1WI多呈等低信号,T2WI均呈混杂高信号,内可见斑片状等低信号,病灶周围常见不完整的低信号环(6/8),增强扫描病变呈不均匀强化;骨质破坏周围多伴有软组织肿块(6/8),部分伴有病理性骨折(3/8)。结论 MRI对骨与软组织恶性纤维组织细胞瘤的诊断缺乏特异性,确诊需依靠病理检查。Objective To explore the MRI representations of malignant fibrous histiocytoma of bone and soft tissue.Methods MRI manifestations of malignant fibrous histiocytoma of bone and soft tissue confirmed by operation and pathology mainly in 18 cases,in which 10 cases were found in soft tissue,8cases in bone were analyzed retrospectively.Results Primary soft tissue malignant fibrous histiocytoma often occured in the deep soft tissue;MRI scan suggested iso-intense or slight hypo-intense signal on T1 WI,and heterogeneous high signal on T2 WI,some had Separated sign（6/10）,pseudomembrane（4/10）and peritumoral edema（2/10）.The solid and solid portion of mass were enhanced obviously.The bone malignant fibrous histiocytoma was arising mainly in the end-of-long bone;MRI scan suggested iso-intense or slights hypo-intense signal on T1 WI,and heterogeneous high signal and patch iso-intense or slight hypo-intense signal on T2WI;Incomplete low signal signal were often seen in most cases（6/8）.The contrast enhanced MRI had heterogeneous density.Bone destruction often had obvious soft tissue masses（6/8）and some cases were associateD with pathological fractures（3/8）.Conclusion MRI manifestations of malignant fibrous histiocytoma of bone and soft tissue are of lack specificity,and the final diagnosis still depends on histopathological examination.

关 键 词：恶性纤维组织细胞瘤 软组织肿瘤 骨肿瘤 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学]