韧带样纤维瘤的磁共振诊断价值  

MRI findings and differential diagnosis of ligamentous

作　　者：宋瑞娟[1] 关长旭[1] 张芳[1] 张凤翔[1] 

机构地区：[1]内蒙古自治区鄂尔多斯市中心医院CT-MRI室,017000

出　　处：《实用医学影像杂志》2017年第6期510-512,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨软组织韧带样纤维瘤(desoid-type fibromatosis,DF)的临床及磁共振成像(MRI)表现。方法收集我院11例经病理证实的DF病例,术前11例均行MRI平扫加增强扫描,分析其MRI各种征象。结果腹壁型2例;腹外型9例,分别发生在胸壁4例,上肢2例,下肢3例。腹外型中有2例分别在术后1年3月和2年4月局部复发。不规则形4例,形态较规则如类圆形、类椭圆形或梭形7例。11例瘤体长轴均与肌纤维走行一致。其中,与周围结构组织界限分明5例,界限不清6例。信号均匀4例,以腹壁型居多,瘤体相对较小;信号不均匀7例,以腹外型居多,瘤体相对较大,其中T1WI呈等信号或稍高信号,T2WI压脂均以高信号为主的等高混杂信号;诸序列中瘤体内均见走行不规则的斑点状、索条状及带状低信号影,此征象更多存在于腹外型DF。增强扫描:瘤体大部分呈明显强化,平扫所示瘤体内低信号影轻度强化或未见明显强化。结论 (1)韧带样纤维瘤具有典型的特征性表现,通过熟知这些征象,可以提高DF的诊断水平;(2)MRI具有软组织高分辨率的优点,可以良好的显示肿瘤形态及与周围结构组织的关系,为手术提供重要直观信息。Objective To investigate the clinical and MRI findings of soft tissue ligamentumoid fibroids （DF）. Methods Collected 11 cases of my hospital by pathology Confirmed DF cases, preoperative 11 cases were MR scan plus enhanced scan, analysis of its MRI various signs. Results Abdominal wall type in 2 cases; abdominal appear-ance in 9 cases, occurred in the chest wall in 4 cases, upper limb in 2 cases, lower limb in 3 cases. There were 2 cases of abdominal surgery in 1 year and 3 months after surgery and 2 years and four months local recurrence. Irregu-lar shape in 4 cases, the shape of the rules such as round, oval or spindle 7 cases. 11 cases of long axis of the tumor and muscle fibers were consistent. Among them, with the surrounding structure of the boundaries of 5 cases, the boundaries were unclear in 6 cases. Signal was homogeneous in 4 cases, mostly abdominal wall type, the tumor was relatively small; signal uneven 7 cases, mostly abdomen, the tumor was relatively large, which T1WI was equal signal or slightly higher signal, T2WI fat to high Signal-based contour mixed signal; the sequence of the tumor were seen in the irregular spot-like, cable-like and band-shaped low-signal shadow, this phenomenon exists more in the abdominal DF Enhanced scan most of the tumor was significantly enhanced, plain scan showed low signal intensity in the tumor enhancement or no significant enhancement. Conclusion ？Ligamentous fibroma has a typical characteristic of the performance, by familiar with these signs, can improve the diagnostic level of DF, （2） MR has the advantages of high resolution of soft tissue, good display of tumor morphology and the relationship between the surrounding tissue and tis-sue, to provide important visual information for surgery.

关 键 词：软组织肿瘤 纤维瘤 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R738[医药卫生—诊断学]