| 程勇,牛艳坤,廖昕,王刚,陈卫国.骨韧带状纤维瘤的影像学表现分析(附12例报告)[J].中国医学影像技术,2006,22(1):125~128 |
| 骨韧带状纤维瘤的影像学表现分析(附12例报告) |
| Imaging features of skeletal desmoplastic f ibromas : report of 12 cases |
| 投稿时间：2005-09-12 修订日期：2005-11-05 |
| DOI： |
| 中文关键词: 骨肿瘤 韧带状纤维瘤 影像诊断 |
| 英文关键词:Bone neoplasms Desmoid tumor Imaging diagnosis |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨骨韧带样纤维瘤的影像学特性,着重研究其MRI 信号表现。方法 回顾性分析经手术病理证实的12 例骨韧带样纤维瘤的放射学和MRI 表现。结果 本组12 例均为单发病灶,四肢管状骨病损7 例:骨干3 例,干骺端4例;其余脊椎2 例,骨盆1 例,颅骨1 例,跟骨1 例。放射学表现:溶骨性破坏11 例;溶骨并粗大的骨脊4 例,其中2 例病变区内见粗细不等、互相交错的“树根”状肿瘤性骨小梁,密度与边缘硬化骨相同;溶骨性改变并有轻微的硬化边3 例;皮质突破占2 例。病变的平均大小8.1cm×3.9cm(纵向和横断位);2 人合并病理性骨折(尺骨、椎体) 。在9 例行MRI 检查的病例中,T1 像上均显示病变区域的信号强度与周围肌肉对比呈等信号或略低信号;在T2 像上有8 例病变组织大部分信号与周围肌肉相等或略低,高信号区域面积均超过病变部分面积的75 %(从各层面测量) ,另外一例(尺骨) 病变区域是大部分呈高信号,并合并有病理性骨折。MRI 和放射学表现在骨内病变的范围是一致的。结论 长骨干骺端为本病好发部位,以溶解膨胀性骨破坏表现为主,X线上病变区域内“树根”状、“根须”状肿瘤性骨小梁形成具有一定特征性, T2WI 呈显著低信号(区域面积超过75 %) 的非成骨性(纤维性) 的骨损害表现具有诊断和鉴别诊断意义。 |
| 英文摘要: |
| Objective To evaluate the imaging features of desmoplastic fibroma of the bone, with an emphasis on MRI sig-nal characteristics. Methods Images of twelve patient s with desmoplastic fibromas proved by pathology were ret rospectivelyreviewed. Results Based on available imaging , there were 7 lesions within the tubular bones : three were diaphyseal , fourmetaphyseal and epiphyseal. The others in the remaining was the vertebrae (n=2), calcaneus (n= 1), pelvis (n= 1),and skull (n=1).Radiographs showed the mat rix was osteolytic in 11 lesions, osteolytic with coarsened ridge-like t rabeculae in 4 lesions , in 2 diseased regions among the 4 lesions present mutually staggered " t ree root" shape tumor bone with the density similarly to the sclerotic rim; mixed lytic and mildly sclerotic in 3 lesions; and mixed lytic and mildly sclerotic in 3 lesions.Cortical breaching was present in 2 lesions. The average size of the lesions was 8.1cm×3.9 cm in greatest longitudinal andt ransverse dimensions. Two patient s had evidence of pathologic f racture. In all cases with MRI, T12weighted sequences showed that the signal intensities within the lesions were isointense or hypointense to adjacent normal muscle. In eight le-sions with short T2, at least in part isointense or hypointense to muscle , the low signal encompassed more than 75 % of the tumor, and the other case in which the lesion did not contain main areas of low T2 signal and was confounded by the presence of an associated pathologic f racture. There was no significant discordance between radiographic and MRI images in the int rao-sseous extent of the tumor. Conclusion Desmoplastic fibromas of long bones are nearly always metaphyseal. Radiographs disclose a expansile lytic lesion with a sclerotic rim and a t rabeculated apperance into it . And the " t ree root" or " root hair"sign is fairly characteristic for this tumor. No calcification and periosteal reaction can be seen. MRI images with T2-weighted sequences were available for review , the most common signal of the lesion was low, occupying more than 75 % of the lesion.The radiologic features of a predominantly osteolytic lesion with prominent T2 shortening on MRI images make a diagnosis of int raosseous desmoid plausible. |
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