骨恶性纤维组织细胞瘤的影像表现

Imanging Features of Malignant Fibrous Histiocytoma of Bone

目的探讨骨恶性纤维组织细胞瘤(MFH)的影像表现,以期提高对该病的认识和诊断水平。资料与方法回顾分析经病理证实的27例MFH的X线平片、CT及MRI的影像学特征。结果长骨20例:干骺端13例,其中股骨近端6例;骨干7例。扁骨或不规则骨7例。股骨近端病变以边界清楚的囊状骨质破坏为主。其他长骨干骺端的病变,以单纯的斑片状骨质破坏或骨质破坏区间夹杂粗细不等的骨嵴为主。骨干病变以虫蚀状、大块或膨胀性的骨质破坏为主。髂骨病变以大块溶骨性骨质破坏为主。坐骨病变以虫蚀状破坏为主,稍膨胀。MRI以长T1、长T2信号为主,其内信号不均匀,增强扫描病变呈不均匀强化。结论MFH影像表现多样,相同发病部位其表现也有相似之处。

Objective To discuss the imaging features of malignant fibrous histiocytoma （MFH） of bone, in order to improve its diagnostic accuracy. Materials and Methods Conventional radiographs, CT and MRI findings of 27 patients with biopsy proven MFH were analyzed retrospectively. Results Tumors were located in long bones in 20 cases ： metaphysis in 13 cases （ of which 6 cases in proximal femur） and diaphysis in 7 cases. Tumors were located in fiat bones or irregular bones in 7 cases. The lesions located in proximal femur mainly appeared as cystic bony destruction with clear margin. Tumors located in other metaphysis appeared as purely destruction of bone or destruction with different crest. Tumors located in diaphysis appeared as mainly osteolytic destructions of mouse eaten pattern. Tumors located in ilium appeared as massive osteolytic destruction. Tumors located in ischium appeared as mainly osteolytic destruction of mouse eaten pattern with slight expansion. The lesions had hypointensity signal on T1WI and hyperintensity signal on T2 WI, and heterogeneous enhanced on T1 weighted image. Conclusion The imaging appearance of MFH are varied in different cases, similar appearance can be seen in same location.