韧带样型纤维瘤病的CT、MRI表现  

CT and MRI findings of desmoid-type fibromatoses

作　　者：谢丽芬[1,2] 梁长虹[2] 李景雷[2] 

机构地区：[1]南方医科大学,广东广州510515 [2]广东省人民医院广东省医学科学院放射科

出　　处：《实用放射学杂志》2015年第1期116-120,共5页Journal of Practical Radiology

摘　　要：目的：探讨韧带样型纤维瘤病（DF）的 CT、MRI 表现。方法回顾性分析经病理证实的29例 DF 患者的影像学资料, CT、MRI 平扫及增强各15例,其中1例同时行 CT、MRI 检查。结果患者中位年龄33.0岁,男女比例约1︰2.2。共检出病灶36个,其中单发26例,多发3例。发生于腹部外19个,腹壁14个,腹内3个。病灶最大长径为13~175 mm。27个病灶呈梭形或椭圆形,9个形态不规则,边界可清楚或不清。25个病灶长轴与肌纤维方向一致。23个病灶浸润性生长,其中16个跨肌腔隙；13个病灶膨胀性生长。CT 发现病灶20个,平扫密度等或稍低于肌肉,多较均匀（15/20）,以中等以上渐进性强化为主,强化均匀或不均匀。MRI 发现病灶17个,T1 WI 均呈等或稍低于肌肉信号,多较均匀（12/17）,T2 WI 呈不均匀稍高或较高信号,增强后显著强化,不均匀强化为主（12/17）；其中11个病灶内见条索状、片状无强化的长 T1短 T2信号影。结论DF 的 CT、MRI 表现具有一定特征性,有助于术前诊断,并显示病灶范围及周围结构受累情况。Objective To investigate the CT and MRI features of desmoid-type fibromatoses（DF）.Methods The images of 29 ca-ses with DF proved by pathology were reviewed retrospectively.CT and MRI examinations were performed in 1 5 cases respectively, and both in 1 case.Results The median age was 33.0 years with a male-to-female sex ratio of 1 ︰ 2.2.36 lesions were discovered,among which 26 cases were solitary while 3 cases had multiple focus.1 9 lesions were extra-abdominal,14 ones in the abdominal wall and 3 ones intra-abdominal.The largest diameter of tumors was 13 -1 75 mm.27 lesions displayed ovoid or elongated shape while 9 ones were irregular .The boundary could be clear or unclear.25 lesions extended along muscle planes with consistent long axis.23 focuses grew aggressively,1 6 of which crossed the muscle clearance,while 13 lesions grew expansively.On CT,20 lesions appeared iso-den-sity or slightly hypo-density compared with normal muscles,mostly homogeneous（1 5/20）.Most lesions exhibited gadually moderate or obvious enhancement on post-contrast CT,and the enhancement was homogeneous or heterogeneous.1 7 lesions were found on MRI,which presented signal intensity similar to or slightly higher than that of muscles on T1 WI and most were homogeneous（12/1 7）;on T2 WI,all were heterogenous with slightly high or high intensity.All lesions demonstrated obvious enhancement on MRI after contrast administration ,and most were heterogeneous（12/1 7）.Sheets or bands of low signal were detected within 1 1 lesions with no enhancement.Conclusion DF has some characteristics on CT and MRI,which are valuable for accurate pre-operative diagnosis,and for evaluation of the lesion extent and involvement of adjacent structures.

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：R730.262[医药卫生—肿瘤] R814.42[医药卫生—临床医学]