结节性筋膜炎的影像学表现与病理特征  

Imaging appearance and clinicopathologic features of nodular fasciitis

作　　者：赵娟 王映伟 陈光祥 唐光才 杨瀚 ZHAO Juan;WANG Ying-wei;CHEN Guang-xiang(Department of Anesthesiology,Sichuan Cancer Hospital&Institute(Sichuan Cancer Center,or Cancer Hospital Affiliated to University of Electronic Science and Technology of China),Chengdu 610041,China)

机构地区：[1]四川省肿瘤医院麻醉科,成都610041 [2]四川省肿瘤医院病理科,成都610041 [3]四川省肿瘤医院影像科,成都610041 [4]西南医科大学附属医院放射科,四川646000

出　　处：《放射学实践》2024年第3期405-409,共5页Radiologic Practice

摘　　要：目的:分析结节性筋膜炎(NF)的影像学表现与病理学特征。方法:回顾性分析经手术病理证实的47例NF的临床、影像及病理学资料,其中男25例,女22例,年龄7~69岁,平均(38.7±12.4)岁。结果:47例NF病灶均为单发,位于上肢占36.2%(17/47),躯干占27.7%(13/47),头颈部占21.3%(10/47),下肢占12.8%(6/47),乳腺占2.1%(1/47)。其中黏液型19例,细胞型12例,纤维型14例,余2例为混合型。黏液型NF病灶中央细胞排列疏松并见液化区,T_(1)WI呈稍低信号,T_(2)WI呈稍高信号,7例可见“反靶征”。细胞型NF细胞成分多且排列紧密,毛细血管分布均匀,增强后5例病灶呈相对均匀强化。纤维型NF病灶中央富含胶原纤维,其中7例相应区域T_(2)WI呈稍低信号,可见星芒状纤维瘢痕改变。结论:结节性筋膜炎的影像学表现可反映其组织病理学改变,“筋膜尾征”及“反靶征”具有一定的诊断价值。Objective:To analyze the imaging appearance and clinicopathologic features of nodular fasciitis(NF).Methods:The clinical data,imaging and pathological materials of 47 patients with NF confirmed by postoperative pathology were analyzed retrospectively.There were 25 males and 22 females,aged from 7 to 69 years,with an average age of(38.7±12.4)years.Results:There were 47 lesions in 47 cases.36.2%(17/47)were located in the upper limbs,27.7%(13/47)in the trunk,21.3%(10/47)in the head and neck,12.8%(6/47)in the lower limbs and 2.1%(1/47)in the breast.All 47 patients were classified into four subtypes:Myxoid,cellular,fibrous and mixed subtype were 19,12,14 and 2 cases respectively.The center cells of myxoid lesions were tightly packed and interspersed with liquefying zone,all the myxoid lesions showed a slight low signal intensity on T_(1)WI and high signal intensity on T_(2)WI,and 7 lesions showed an"inverted target"sign.The cells of cellular lesions were arranged closely and capillaries were distributed evenly;the lesions demonstrated homogenous signal intensity on MRI and homogeneously marked enhancement after contrast administration in 5 cases.The center of fibrous lesions were abundant in collagen with a slight low signal intensity on T_(2)WI in corresponding region,and the"central fibrotic scar"sign can be demonstrated in 7 cases.Conclusion:Imaging appearance manifestations of NF bear certain relationship with the course of disease and the histological subtypes,the"fascia tail"sign and"inverted target"sign have a certain diagnostic significance.

关 键 词：结节性筋膜炎 体层摄影术 X线计算机 磁共振成像 病理学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R686.3[医药卫生—诊断学]