隆突性皮肤纤维肉瘤的CT和MRI表现  

The manifestation of dermatofibrosarcoma protuberans on CT and MRI

作　　者：王传彬[1] 韦超[1] 李乃玉[1] 林婷婷[1] 吴瑶媛[1] 高飞[1] 董江宁[1] WANG Chuan-bin;WEI Chao;LI Nai-yu(Department of Medical Imaging,Anhui Provincial Cancer Hospital(The First Affiliated Hospital of USTC West District),Hefei 230031,China)

机构地区：[1]安徽省肿瘤医院(中国科学技术大学附属第一医院西区)影像科,安徽合肥230031

出　　处：《中国医学装备》2021年第4期58-61,共4页China Medical Equipment

基　　金：国家癌症中心攀登基金临床研究课题2018年度立项课题(NCC201812B035)“3.0T磁共振体素内不相干运动扩散加权成像与动态对比增强成像、影像组学在肌骨肿瘤中的精准诊断、骨肉瘤新辅助化疗疗效评估中的应用研究”;安徽省肿瘤医院院内青年基金(2020YJQN010)“定量CT在乳腺癌患者治疗期间骨健康、营养状态的影像学评价以及恶液质预警中的应用研究”。

摘　　要：目的:探讨隆突性皮肤纤维肉瘤(DFSP)的CT及磁共振成像(MRI)表现,以提高诊断准确率。方法:选择经手术病理证实的12例DFSP患者CT及MRI影像资料,分析其肿瘤的发病部位、病灶起源、病灶大小及数量、病灶生长方式及形态、密度与信号、强化模式以及与邻近结构关系等影像学特征。结果:12例DFSP患者的发病部位中发生于躯干7例(占58.3%),四肢3例(占25%),头颈部2例(占16.7%),共33个病灶。病灶起源于皮下纤维组织1例,起源于皮肤11例;病灶的平均直径(2.76±0.82)cm。病灶生长方式和形态中以膨胀性生长为主的病灶27个,表现为类圆形或浅分叶状;以浸润性生长为主的病灶6个,表现为扁平状或深分叶状。CT平扫均呈等-稍低密度;MRI的T_(1)WI均呈等低信号,T_(2)WI均呈稍高信号,T_(2)WIFS及DWI序列均呈明显高信号。2例DFSP患者行CT增强后均呈中等度以上渐进性强化,3例行MRI增强后均呈明显不均匀强化,内均可见索条状差强化区。3例累及浅筋膜深层及周围脂肪,可见"筋膜尾征";2例悬吊于皮肤外,表现为"悬吊征",4例为多结节融合改变,表现为"多结节征"及"子结节外突征"。结论:DFSP好发于躯干及四肢,CT平扫密度与MRI信号均与肌肉相仿,T_(2)WI-FS及DWI序列呈明显高信号,病灶内常见低信号纤维成分,增强后明显不均匀强化。Objective:To investigate the manifestation of dermatofibrosarcoma protuberans(DFSP)on computed tomography(CT)and magnetic resonance imaging(MRI)so as to improve the diagnostic accuracy.Methods:The image data of CT and MRI of 12 patients with DFSP who were confirmed by surgery and pathology were selected and were analyzed retrospectively.And their imaging features,included pathogenic site of tumor,the origin of lesion,the size and number of lesion,the growth pattern and morphology of lesion,the density/signal,reinforcement model and the relation between tumor and adjacent to structure etc.,were analyzed.Results:In 12 patients with DFSP,the incidence site of 7 cases(58.3%)occurred in trunk,and 3 cases(25%)occurred in limbs,and 2 cases(16.7%)occurred in head and neck,with 33 lesions in total.And the origin of lesions of 1 case were in subcutaneous fibrous tissue and 11 cases originated from skin,and the average diameter was 2.76±0.82 cm.In growth mode and morphology of lesion,27 lesions(81.8%)were mainly distended growth,which appeared like-round or shallow lobulation,and 6 lesions(18.2%)were mainly invasive growth,which appeared tabular or deep lobulation.CT plain scan showed equal-slightly low density.T_(1) WI all showed equally low signal,and T_(2) WI all showed slightly high signal,and T_(2) WI-FS and DWI sequences appeared obviously high signal.2 patients with DFSP showed progressive enhancement above moderate degree after underwent CT enhancement,and 3 patients with DFSP showed obviously uneven enhancement after underwent MRI enhancement,and all of them showed cord-like and patchy enhancement regions.3 cases involved to the deep layer of superficial fascia and showed"fascia tail sign".And 2 cases lesions overhung outside the skin,and showed"overhang sign",and 4 cases showed multi-nodule fusion changes,which appeared"multi-nodule sign"and"sub-nodular protrusion sign".Conclusion:The most of DFST occurred in trunk and limbs,which density/signal of plain scan was similar with muscle,and which T_(2) WI-FS and DWI

关 键 词：隆突性皮肤纤维肉瘤(DFSP) 体层摄影术 X射线计算机 磁共振成像(MRI) 

分 类 号：R816[医药卫生—放射医学]