MRI在软组织内恶性纤维组织细胞瘤的临床应用价值  

Clinical application value of MRI on malignant fibrous histiocytoma in soft tissue

作　　者：徐万里[1] 吴晓[1] 钱海峰[1] 刘东[1] 

机构地区：[1]湖州市中心医院放射科,浙江湖州313000

出　　处：《中国骨伤》2017年第12期1135-1140,共6页China Journal of Orthopaedics and Traumatology

摘　　要：目的 :探讨MRI在软组织内恶性纤维组织细胞瘤的影像学表现及临床应用价值。方法 :回顾性分析2009年1月至2016年8月经手术病理证实的16例软组织恶性纤维组织细胞瘤患者的MRI影像及病理资料,其中男9例,女7例;年龄34~67岁,平均52岁;病程5~48个月,平均27个月。临床主要表现为软组织肿块和局部疼痛。术前均进行MRI平扫及增强检查。术后观察其发病部位、MRI表现及病理结果。结果:16例患者中13例为原发病灶,3例为术后复发病灶。发病部位为:大腿9例,小腿2例,上臂2例,臀部1例,踝部1例,腰背部1例。16例肿瘤均形态多变,主要以梭形、类圆形及不规则多见。大小5.3~16.9 cm,平均8.6 cm。MRI在T1WI上16例均呈略低信号或等信号,其中6例肿瘤内见混杂信号;在T2WI均呈高信号,其中7例肿瘤内部可见低信号分隔,5例肿瘤可见假包膜,11例肿瘤同周围分界不清伴水肿。增强后肿瘤呈明显不均匀强化。免疫组化见Vim、CD68阳性。结论:恶性纤维组织细胞瘤的MRI表现虽然具有一定特征性,但定性较困难,最终需要病理及免疫组化确定。但MRI检查对明确肿瘤范围,是否侵犯周围血管、神经等具有明显优势,对临床手术方案及术后肿瘤是否有残留、复发具有重要的临床应用价值,对临床疗效提供参考依据。Objective：To investigate imaging manifestation and clinical application of MRI on malignant fibrous histiocytoma（MFH） in soft tissue. Methods：Imaging and pathological data of 16 patients with malignant fibrous histiocytoma（MFH）in soft tissue confirmed by surgery and pathology were retrospectively analyzed from January 2009 to August 2016. There were9 males and 7 females,aged from 34 to 67 years old with an average of 52 years. The courses of disease ranged from 5 to 48 months with an average of 27 months.The main clinical manifestations were soft tissue mass and local pain. All patients were underwent plain and enhanced MRI before operation. Pathogenic sites,MRI manifestation and pathology results were observed after operation. Results：MRI in 16 cases of T1 WI showde slightly lower signal or equal signals,of which 6 cases of tumor see mixed signal;in T2 WI were high signal,of which 7 cases of internal tumor can be seen low signal separation,5 cases of turor can be seen flase envelope,11 cases of tumor with the surrounding boundaries unclear with edema. All lesions showed significantly uneven enhancement. Immunohistochemical examination showed that Vim,CD68 was positive. Conclusion：Although MRI features of MFH has certain characteristics,the qualitative was more difficult,and ultimately need to determine the pathological and immunohistochemical. But MRI examination has obvious advantages in clarifying range of tumor,invading peripheral blood vessels and nerves,and has important clinical application value for clinical operation plan and postoperative tumor residual and recurrence,and provid reference for clinical curative effect.

关 键 词：磁共振成像 软组织肿瘤 组织细胞瘤 恶性纤维 

分 类 号：R738.6[医药卫生—肿瘤]