隆突性皮肤纤维肉瘤临床及影像特征分析  

Clinical and Imaging Characteristics Analysis of Dermat of ibrosarcoma Protuberans

作　　者：肖阳 薛影 梁寿衡 XIAO Yang;XUE Ying;LIANG Shou-heng(Medical Ultrasound Center,Northwest Women and Children's Hospital,Xi'an 710038,Shaanxi Province,China;Department of Radiology,Tangdu Hospital,Xi'an 710038,Shaanxi Province,China)

机构地区：[1]西北妇女儿童医院医学超声中心 [2]唐都医院放射科,陕西西安710038

出　　处：《中国CT和MRI杂志》2024年第11期174-176,共3页Chinese Journal of CT and MRI

摘　　要：目的总结隆突性皮肤纤维肉瘤(DFSP)临床及影像学特征,提高临床诊断水平。方法回顾分析我院32例DFSP患者的体格检查、病理学资料、超声特征(形态及边界、内部回声、血供情况等)、CT特征(密度、有无钙化、坏死出血等)、MRI特征(平扫及增强信号、瘤周水肿、有无弥散受限及深部浸润淋巴结转移等)。结果32例DFSP的平均年龄42.3±6.2(岁),首发/复发(19例/13例),复发年限5至18年,复发区域常为手术瘢痕区,极少远处及淋巴结转移。均表现为CD34和Vimentin阳性或强阳性,Ki67值范围3-20%。常位于躯干和四肢,表现为单发无痛质韧结节或肿块。超声呈不均匀低回声伴内部丰富血流,边界清晰。CT上密度均匀一致,且低于肌肉密度,无钙化坏死出血成分。MRI可见双低信号及“脂肪尾征”、“皮肤尾征”和“筋膜尾征”;轻微瘤周水肿或无水肿;中度至显著强化;DWI呈高信号,ADC值显著减低。结论DFSP的发病率相对较低,易复发易误诊,临床及影像具有一定特征性。Objective Summarize the clinical and imaging features of dermatofibrosarcoma protuberans(DFSP)to improve clinical diagnosis level.Methods Retrospective analysis of physical examination,pathological materials,ultrasound features(morphology and boundaries,internal echoes,blood supply,etc.),CT features(density,presence of calcification,necrosis and bleeding,etc.),MRI features(plain and enhanced signals,peritumoral edema,presence of diffusion restriction,and deep infiltration and lymph node metastasis,etc.)of 32 patients with DFSP in our hospital.Results The average age of 32 cases of DFSP was 42.3±6.2 years,with initial/recurrent(19 cases/13 cases)and a recurrence period of 5 to 18 years.The recurrence area was often the surgical scar area.Very little distant and lymph node metastasis.Both show CD34 and Vimentin positivity or strong positivity,with a Ki67 value range of 3-20%.Often located in the trunk and limbs,it presents as a single painless tough nodule or mass.Ultrasound shows nonuniform low echo with rich internal blood flow and clear boundaries.The density on CT is uniform and lower than muscle density,with no calcification,necrosis,or bleeding components.MRI shows double low signal,as well as"fat tail","skin tail",and"fascia"sign;Mild peritumoral edema or no edema;Moderate to significant enhancement;DWI shows high signal and ADC value significantly decreases.Conclusion The incidence rate of DFSP is relatively low,easy to recur and misdiagnose,and has some specific clinical and imaging features.

关 键 词：隆突性皮肤纤维肉瘤 超声 计算机断层扫描 磁共振成像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学]