低度恶性肌纤维母细胞肉瘤的影像诊断价值  

Imaging Diagnostic Value of Low-Grade Malignant Myofibroblast Sarcoma

作　　者：杨倩 陈楠 余筱瑶 苏佳佳[1] 姚义好 YANG Qian;CHEN Nan;YU Xiaoyao(Department of Radiology,Hubei Cancer Hospital,Wuhan,Hubei Province 430079,P.R.China)

机构地区：[1]湖北省肿瘤医院放射科,武汉430079 [2]华中科技大学同济医学院附属同济医院放射科,武汉430030

出　　处：《临床放射学杂志》2024年第2期283-287,共5页Journal of Clinical Radiology

摘　　要：目的探讨CT和MRI在诊断低度恶性肌纤维母细胞肉瘤(LGMS)中的价值,以提高对该病的认识。方法回顾性分析10例行CT和(或)MRI检查并经手术或穿刺、病理和免疫组织化学证实LGMS的患者资料,女2例,男8例,年龄33~81岁,平均60.2岁;其中3例行CT平扫及增强扫描,3例行MR平扫及增强扫描,4例同时行CT、MRI平扫及增强扫描,分析LGMS的影像学表现及特点。结果1例位于舌,3例位于四肢,2例位于腹壁,1例位于腰臀部,胸壁1例,腹腔2例;病灶最大直径52~277 mm,平均直径约79.6 mm;7例CT平扫病灶与肌肉密度相比,1例呈低密度,1例呈等密度,5例等低混杂密度,以等密度为主;CT增强扫描2例轻中度强化,5例明显不均匀强化。7例MRI平扫与同层肌肉信号相比,T_(1)WI信号不等,3例呈低信号,4例病灶中心T_(1)WI序列上可见“岛屿状”、“溏心鸡蛋”样高信号,病灶边缘T_(1)WI序列上呈低信号;T_(2)WI呈混杂信号,病灶中心以高信号为主;增强扫描8例病灶边缘均明显不均匀强化,即呈环形强化,病灶中心均可见无强化区;其余2例呈明显不均匀强化,强化特点无特征性。结论LGMS病灶体积较大,密度或信号大多不均匀,大多数病灶中心可见大片状低密度影或短T_(1)、长T_(2)信号,呈“岛屿状”、“溏心鸡蛋”样高信号,增强后大多数病灶中心无强化、周边明显不均匀强化,呈环形强化,对诊断该肿瘤具有重要的价值。Objective To explore the value of CT and MRI in the diagnosis of low-grade malignant myofibroblast sarcoma(LGMS)in order to improve the understanding of this disease.Methods the data of 10 patients with LGMS confirmed by CT and/or MRI,including 2 female and 8 male,aged 33-81 years(mean 60.2 years),were retrospectively analyzed;Among them,3 cases underwent CT plain scan and enhanced examination,3 cases underwent MR plain scan and enhanced examination,and 4 cases underwent CT and MRI plain scan and enhanced examination at the same time.The imaging manifestations and characteristics of LGMS were analyzed.Results 1 case was located in the tongue,3 cases in the limbs,2 cases in the abdominal wall,1 case in the waist and buttocks,1 case in the chest wall and 2 cases in the abdominal cavity;The maximum diameter of the lesion was 52-277 mm,and the average diameter was about 79.6 mm;Compared with muscle density in 7 cases of CT plain scan,1 case showed low density,1 case showed isodensity,5 cases showed isolow mixed density,mainly isodensity;In contrast-enhanced CT scan,2 cases had mild to moderate enhancement and 5 cases had obvious uneven enhancement.Compared with the muscle signal of the same layer,the signal of 7 cases on MRI plain scan was low on T_(1)WI,of which 4 cases showed“island like”and“soft egg like”high signal,and T_(2)WI showed mixed signal.The focus center was mainly high signal,and the focus on enhanced scan was obviously non-uniform enhancement,showing flower ring changes.Conclusion LGMS lesions are large in size,and most of the density or signal are non-uniform.Large low-density shadows or short T_(1) and long T_(2) signal shadows can be seen in the center of the lesions,showed“island like”and“soft egg like”high signal.Most of the enhanced lesions have obvious non-uniform enhancement around the periphery,showing ring enhancement.It is of great value for the diagnosis of LGMS.

关 键 词：LGMS 体层摄影术 X线计算机 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] R730.44