MRI对四肢韧带样纤维瘤病的诊断价值  

The value of MRI in the diagnosis of desmoid-type fibromatosis of extremities

作　　者：王小强[1] 王唯伟 陈月芹[1] WANG Xiaoqiang;WANG Weiwei;CHEN Yueqin(Department of Radiology,Affiliated Hospital of Jining Medical University,Jining 272029,P.R.Chin)

机构地区：[1]济宁医学院附属医院影像中心,山东济宁272029

出　　处：《医学影像学杂志》2018年第7期1204-1207,1210,共5页Journal of Medical Imaging

基　　金：山东省医药卫生科技发展计划项目(编号:2016WS0185)

摘　　要：目的探讨四肢韧带样纤维瘤病的MRI特征,提高对其诊断水平。方法回顾性分析30例经手术病理证实的韧带样纤维瘤病患者的MRI资料。结果 30例患者中26例病灶位于浅筋膜下,4例位于深部肌间隙内;18例呈梭形,8例呈类圆形(2例伴浅分叶),不规则形4例;24例病变边界不清,其中20例呈"爪状"或"树根状"浸润生长,6例病变边界尚清晰;肿块平均长径约(6.7±2.1)cm,(范围2.0~15.1cm);MRI信号不均匀,但无坏死、囊变,T1WI呈等或稍低信号,T2WI多呈混杂高信号,18例肿块内见星芒状或条索状低信号,20例增强扫描均呈不均匀明显强化,其内星芒状或条索状低信号区未见明显强化,2例动态增强扫描呈"快进-慢出"改变,8例DWI呈不均匀高信号,ADC呈稍高信号。结论四肢韧带样纤维瘤病MRI表现具有特征性,对于术前诊断及鉴别诊断具有重要价值。Objective To investigate the MRI characteristics of desmoid-type fibromatosis （DF） of extremities so as to improve the diagnositc accuracy. Methods The MRI data of 30 patients with desmoid fibromatosis confirmed by surgery and pathology were analyzed retrospectively. Results Of the 30 patients,26 lesions were located under the superficial fascia, and and 4 cases were located in the deep intermuscular space. Eighteen cases were spindle shapes, 8 cases showed round shapes （2 cases with shallow lobulated）, 4 cases showed irregular shapes. The boundary of 24 lesions was not clear, 20 of them showed ＂claw like＂ or ＂root like＂ infiltrations, and the borders of 6 cases were still clear. Lesions were 2.0~15.1 cm in size. On MRI, the lesions were characterized by inhomogeneous signal, but no necrosis or cystic. On T 1WI, the lesions showed hypo-signal or iso-signal intensity. On T 2WI, all cases showed heterogeneous hype-signal intensity. Eighteen cases showed Asterism-like or streak-like areas with hypointensity in the lesions. Twanty cases showed inhomogeneous enhancement, 8 cases showed progressive enhancement, and 18 cases showed no enhancement in Asterism-like or streak-like areas of T 2WI. Two cases of dynamic enhanced scans showed ＂fast in slow out＂. Eight cases showed heterogeneous hype-signal intensity, slightly hype-signal intensity in ADC. Conclusion The MRI manifestations of DF have some characterastics, which are of great value for its preoperative dagnosis.

关 键 词：韧带样纤维瘤病 诊断 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]