原发长骨良性纤维组织细胞瘤的影像表现及鉴别  

Imaging diagnosis of primary benign fibrous histiocytoma of long bones

作　　者：衣利磊[1] 张家雄[1] 周守国[1] 王娟[1] 谢乐[1] 郭月飞[2] 

机构地区：[1]广州中医药大学附属佛山市中医院放射科,广东佛山528000 [2]中山大学附属第三医院放射科,广东广州510080

出　　处：《影像诊断与介入放射学》2016年第3期225-229,共5页Diagnostic Imaging & Interventional Radiology

基　　金：佛山市重点专科培育项目建设资助

摘　　要：目的探讨原发长骨良性纤维组织细胞瘤(BFH)的影像表现及鉴别诊断。方法回顾性分析29例证实的原发长骨良性纤维组织细胞瘤患者的临床及影像学资料。结果本组病例病变均单发,其中股骨14例,胫骨7例,肱骨5例,腓骨2例,锁骨1例,其中29例均行X线检查,21例行CT检查,17例行MRI检查;X及CT示病变呈偏心性或中心性的不同程度膨胀性骨质破坏,边界清楚,均有硬化边,未见软组织肿块。X线中,4例位于骨端关节面下偏心性生长,19例位于干骺端偏心性生长,6例位于骨干呈中心性生长,9例合并病理骨折。CT显示骨质破坏区为与肌肉密度相仿的软组织密度影,4例合并病理骨折,未见骨膜反应;MRI中病灶边缘均见低信号边,5例病灶信号较均匀,12例信号混杂不均合并囊变,T_2WI病灶内见斑片状及条片状低信号影,增强后肿瘤实性部分明显强化。结论原发长骨良性纤维组织细胞瘤影像表现具有一定特征性,综合分析临床资料及影像表现有助于提高术前诊断准确性。Objective To assess the imaging features of primary benign fibrous histiocytoma of long bones. Methods A retrospective analysis was performed to assess the imaging appearance of 29 histologically confirmed primary benign fibrous histiocytomas of long bones. Results All 29 tumors were solitary and located in the femur （14）, tibia （7）, humerus （5）, fibula （2）, and clavicle （1）. Radiographs （29） and CT （21） showed varying degrees of centric or eccentric expansile osteolysis with well-defined sclerotic border and no soft tissue mass...On x-ray,.the bone destruction was eccentric in the epiphysis. （4）.and metaphysis （19）, centrally in the diaphysis （6）, and associated with pathological fractures （9）. CT showed bone destruction isodense relative to soft tissue, pathological fractures （4）, and no periosteal reaction. MRI （17） findings included hypointense sclerotic rim （17）, homogeneous tumor signal intensity （5）, heterogeneous signal intensity with cyst change （12）, patchy T2 hypointensity,.and contrast enhancement in the solid component of the tumor. Conclusion Imaging characteristics can aid the diagnosis of primary benign fibrous histiocytoma of long bones.

关 键 词：长骨 良性纤维组织细胞瘤 体层摄影术 X 线计算机 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2