骨促结缔组织增生性纤维瘤的影像诊断与鉴别诊断  

Imaging diagnosis and differential diagnosis of desmoplastic fibroma of bone

作　　者：钟志伟[1] 马洁琳 王勇 郭哲[1] 陈伟[4] 吴文娟[1] Zhong Zhiwei;Ma Jielin;Wang Yong;Guo Zhe;Chen Wei;Wu Wenjuan(Department of Radiology,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Department of Radiotherapy,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China;Department of Radiology,Hospital of Gucheng County,Gucheng 253800,China;Institute of Orthopaedics,the Third Hospital of Hebei Medical University,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院放射科,石家庄050051 [2]河北医科大学第三医院放疗科,石家庄050051 [3]河北省故城县医院放射科,253800 [4]河北医科大学第三医院骨科,石家庄050051

出　　处：《中华老年骨科与康复电子杂志》2020年第3期165-170,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：2017河北省科技厅课题(17277779D)。

摘　　要：目的分析骨促结缔组织增生性纤维瘤的影像学表现,总结骨促结缔组织增生性纤维瘤的影像学诊断特点和鉴别诊断要点。方法回顾性分析2002年1月至2019年10月经病理证实的13例骨促结缔组织增生性纤维瘤的X线、CT和MRI,分析影像学表现包括:发病部位、骨质破坏情况、病变内的骨质密度、病变区的MR信号特点及周围侵袭性特点。结果13例骨促结缔组织增生性纤维瘤患者中,男性7例,女性6例,年龄为2~52岁,中位年龄27岁。本组13例的发病部位是长骨8例,髂骨3例,椎体及跟骨各1例。长骨常见于干骺端,可累及骨干及骨端。丝瓜瓤型6例,溶骨型3例,混合型3例,骨旁型1例。病变区内的CT值30~60 Hu(6例CT值大于45 Hu)。具有MRI检查的8例患者中5例表现为T1WI呈不均匀等或低信号,T2WI呈不均匀等或高信号,其内可见T1WI、T2WI均为低信号区域;3例病变区呈均匀长T1长T2信号。13例DFB中9例病变周围可见软组织肿块。结论骨促结缔组织增生性纤维瘤具有侵袭性,以丝瓜瓤型多见,病变区存在T1WI、T2WI均为低信号,有助于其诊断及鉴别诊断。Objective To analyze the imaging features of desmoplastic fibroma of bone(DFB)and summarize its imaging diagnosis characters and differential diagnosis.Methods Retrospectively analyzed the X-ray,CT and MRI of 13 cases of DFB were confirmed by pathology from January 2002 to October 2019,and analyzed the imaging findings,including the location of the tumor,the destruction of the bone,and the bone of density in the lesion,characteristics of magnetic resonance signals and range of encroachment.Results There were 7 males and 6 females,aged from 2-52 years old,more common in adolescents under 30 years old.8 cases occurred at long bone,3 cases occurred at sacrum and 1 case of vertebra and calcaneus.DFB is common in the metaphysis of long bones,and it can involve the diaphysis and epiphysis.There were 6 cases of loofah cyst type,3 cases of osteolytic type,3 cases of mixed type,and 1 case of parabone type.CT value is30-60 Hu in the lesion area(6 cases CT value>45 Hu).5 cases showed low mixed signals on T1 WI and high mixed signals on T2 WI,and showed low signals on T1 WI and T2 WI in the region.3 cases showed Homogeneous low signal on T1 WI and high signal on T2 WI.9 patients had soft tissue lumps.Conclusions DFB is a rare tumor with strong local aggressiveness,the loofah cyst type was more common in DFB,the low signals on T1 WI and T2 WI in the lesion,which are helpful for diagnosis and differentiate diagnosis of the disease.

关 键 词：骨肿瘤 纤维瘤 结缔组织增生 影像诊断 

分 类 号：R738.1[医药卫生—肿瘤]