骨低度恶性肌纤维母细胞肉瘤的X线与MRI表现与病理对照分析

X-ray and MRI Findings of Low-grade Myofibroblastic Sarcoma in Bone with Comparison of Pathology

目的探讨骨低度恶性肌纤维母细胞肉瘤的影像特点,提高其影像诊断水平。方法回顾性分析12例经病理证实的骨低度恶性肌纤维母细胞肉瘤的X线与MRI表现。结果12例骨低度恶性肌纤维母细胞肉瘤中,8例位于下肢长骨,3例位于扁骨,1例位于不规则骨。所有病例均行X线检查,4例呈斑片状、筛孔样、虫蚀样骨质破坏,无硬化边,8例呈大片状、溶骨性骨质破坏,瘤周可见不规则硬化带,所有病例均无骨膜反应。7例行MRI检查,肿瘤T1WI呈等低不均匀信号,T2WI呈混杂高信号,增强扫描肿瘤以周缘强化显著。结论骨低度恶性肌纤维母细胞肉瘤罕见,X线显示骨质破坏具有"双重性"特点,组织病理学和免疫组织化学检查是唯一能够对其确诊的金标准。

Objective Exploring imaging diagnosis of low-grade myofibroblastic sarcoma in bone to improve diagnosis.Methods A retrospective analysis was made on X-ray and MRI findings and pathological findings of 12 cases with pathologically approved low-grade myofibroblastic sarcoma in bone.Results In the 12 cases of low-grade myofibroblastic sarcoma,8 cases occurred in the long bone of lower limbs,3 cases occurred in the flat bone,and 1 was located in the irregular bone.All the patients had an X-ray examination performed,and 4 cases showed patchy、sieve-like and vermiform bone destruction without marginal sclerosis,8 cases showed large patchy and osteolytic lesions,and all cases had no periosteal reaction.7 cases of MRI examination showed long T1 and long T2 signal shadows of the tumor,and the enhancement scan showed significant peripheral enhancement of the tumor.Conclusion Low-grade myofibroblastic sarcoma of bone is rare.X-ray shows that the bone destruction had dual characteristics,therefore histopathology and immunohistochemical examinations were the only gold stangard for diagnosis.