韧带样型纤维瘤病的影像学诊断  

Imaging Diagnosis of Desmoid-Type Fibromatosis

作　　者：陈杰云[1] 林晓莹[1] 黄日升[1] 杨子江[1] 陈向荣[1] 

机构地区：[1]福建医科大学附属泉州第一医院影像科,泉州362000

出　　处：《临床放射学杂志》2014年第8期1243-1247,共5页Journal of Clinical Radiology

摘　　要：目的探讨软组织韧带样型纤维瘤病(DF)的影像学特征,提高对该病的认识及诊断准确率。方法回顾性分析经手术病理证实的21例DF患者临床及影像资料,观察病变位置、大小、边缘、形态、密度及信号特点、强化方式。结果 21例中,腹部外型12例,腹壁型7例,腹内型2例。肿瘤呈浸润性生长13例,其形态多不规则,边界不清楚;呈膨胀性生长8例,边界清楚。CT平扫病灶呈低密度或等密度,增强扫描9例表现为渐进性、持续性强化特征。MRI信号不均匀,T1WI呈等、低信号,T2WI呈略高或高信号,STIR为高信号,7例于各序列内均见斑片、条索状低信区。7例行增强扫描均呈明显强化,亦呈渐进性、持续性强化,低信号区无强化。结论 DF的CT和MRI表现具有一定的特征性,对该病有较高的诊断及鉴别诊断价值。Objective To discuss the imaging features of soft tissue desmoid-type fibromatosis （DF） in order to improve the knowledge and diagnostic accuracy of DF. Methods The clinic data and CT as well as MRI findings of 21 cases with pathologically-confirmed DF were retrospectively analyzed. The imaging features, including the location, size, edge, shape, density, signal intensity and enhancement pattern of the lesions were evaluated. Results Of the 21 patients with DF, extra-abdominal type was seen in 12, abdominal wall type in 7 and intra-abdominal type in 2. The tumor took the form of infiltrative growth pattern in 13 cases, and the lesion was irregular in shape with ill-defined margin. Expansive growth pattern was demonstrated in 8 cases, and the lesions had a well-defined border. On plain CT scans, the lesions were lowdensity or iso-density, while on enhanced CT scans the lesions showed progressing and persistent enhancement. On MRI, the lesions were characterized by inhomogeneous signal, iso-intensity or hypo-intensity signal on T1WI, hyper-intensity or slight hyper-intensity signal on T2 WI and hyper-intensity signal on STIR images. In 7 cases, patch and linear low-intensity signal area could be observed on images of all scanning sequences. Enhanced MR scanning was employed in 7 patients, and the lesions showed striking enhancement, which was progressing and persistent. No enhancement was found in low-intensity signal areas. Conclusion Desmoid-type fibromatosis carries certain CT and MRI features, which are of great value for its diagnosis and differentiation.

关 键 词：韧带样型纤维瘤病 体层摄影术 X线计算机 磁共振成像 增强 诊断 

分 类 号：R738.6[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2