基于MDM2基因扩增状态比较四肢软组织脂肪瘤与非典型性脂肪瘤性肿瘤的MRI特征  

Comparison of MRI features of soft tissue lipomas and atypical lipomatous tumor in extremities based on MDM2 gene amplification status

作　　者：刘鸿利 徐磊[1] 时寅 祁良[1] 冯阳[1] 邹月芬[1] 宗敏[1] LIU Hongli;XU Lei;SHI Yin;QI Liang;FENG Yang;ZOU Yuefen;ZONG Min(Department of Radiology,the First Afiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院放射科,江苏南京210029

出　　处：《实用放射学杂志》2023年第7期1147-1151,共5页Journal of Practical Radiology

摘　　要：目的 通过MRI与组织学和MDM2扩增状态鉴别脂肪瘤与非典型性脂肪瘤性肿瘤(ALT).方法 以组织学和荧光原位杂交(FISH)MDM2扩增状态为标准,纳入104例四肢脂肪瘤性患者,其中脂肪瘤54例,ALT 50例.由2名放射科医生评估术前MRI影像学特征,包括肿瘤最大径、受累部位(肌内,肌间或皮下)、分隔或结节(无或厚度<2 mm,厚度≥2 mm或有结节)以及肿瘤内对比增强(<1/3肿瘤体积,≥1/3肿瘤体积).结果 50例ALT患者中,39例(78.0%)表现为厚分隔(≥2 mm),其可以增加ALT诊断的可能性(P<0.001),40例(80.0%)肿瘤最大径≥95 mm,最大径较大可增加ALT的可能性(P<0.001),肿瘤内对比增强也增加了ALT的可能性(P<0.001).54例脂肪瘤患者中,11例(20.4%)位于皮下,35例(64.8%)位于肌内和8例(14.8%)位于肌间.而ALT不发生于皮下,大多数位于肌间(86.0%),少数位于肌内(14.0%).结论 特定的MRI成像形态特征(肿瘤最大径、厚分隔和对比增强)和脂肪瘤性肿瘤的定位信息是诊断脂肪瘤和ALT的重要预测因子.Objective To assess the diagnostic performance of MRI in the differentiation of lipomas and atypical lipomatous tumor(ALT)in comparison with histology and MDM2 amplification status.Methods A total of 104 lipomatous tumors located in the extremity were included in this study.Histology and MDM2 amplification status by fluorescence in situ hybridization(FISH)were used as standards.Among the patients,54 patients were diagnosed with lipoma and 50 patients were ALT.Preoperative MRI imaging features were retrospectively evaluated by two radiologists,including maximum tumor diameter,site of involvement(intramuscular,intermuscular,or subcutaneous),internal septa or nodules[absent,thin(<2 mm)or thick septa(≥2 mm)with nodular components],and intra-tumoral contrast enhancement(<1/3 of the tumor volume,≥1/3 of the tumor volume).Results Among 50 patients with ALT,39(78.0%)showed thick septa(≥2 mm),which increased the likelihood of ALT diagnosis(P<0.001).Furthermore,40(80.0%)patients presented the maximum diameters of the tumor,which were greater than 95 mm.The likelihood of ALT would increase if the maximum diameter of the tumor was greater than 95 mm(P<0.001).The presence of contrast enhancement within the tumor also increased the likelihood of ALT(P<0.001).Among the 54 cases of lipoma,11(20.4%)were located subcutaneous,35(64.8%)intramuscular,and 8(14.8%)inter-muscular,none of the ALT lesions were located subcutaneous,most were located inter muscular(86.0%),and a few were located intramuscular(14.0%).Conclusion Specific MRI morphological characteristics(maximum tumor diameter,thick septa,and contrast enhancement)and location of the lipomatous tumors are several significant predictive factors for the diagnosis of lipomas and ALT.

关 键 词：脂肪瘤 非典型性脂肪瘤性肿瘤 MDM2基因 磁共振成像 

分 类 号：R738.6[医药卫生—肿瘤] R445.2[医药卫生—临床医学]