原发性骨恶性纤维组织细胞瘤的CT和MRI诊断

CT and MRI diagnosis of primary malignant fibrous histiocytoma of bone

目的:探讨原发性骨恶性纤维组织细胞瘤(BMFH)的CT和MRI表现,以提高影像诊断水平。方法:收集经手术病理证实的原发性BMFH 13例,9例行CT检查,其中行增强扫描3例;6例行MRI检查,其中行增强扫描2例;2例同时行CT和MRI检查。分析原发性BMFH的CT和MRI表现,并与组织病理学表现相对照。结果:13例中,长骨骨端11例,长骨骨干1例,髂骨1例。骨质表现为溶骨性破坏,其中6例病灶边缘有轻度骨硬化,7例骨质破坏区间夹杂粗细不等的骨嵴,骨膜反应1例;MRI表现为T1WI等低信号,T2WI混杂高信号。13例均见超过骨破坏范围的软组织肿块,钙化1例;T1WI表现为等或等低信号,T2WI为等高或混杂高信号。CT、MRI增强扫描病变不均匀强化。结论:原发性BMFH的CT、MRI表现有一定的特征,能较好地反映病变的病理特点,对术前明确诊断具有重要意义。

Objective：To evaluate the CT and MRI manifestations of primary malignant fibrous histiocytoma of bone（BMFH） so as to improve imaging diagnosis ability of disease.Methods：CT and MRI manifestations of 13 patients with primary BMFH confirmed by operation and pathology were retrospectively analyzed.9 patients were examined by CT（3 with enhanced scan）,6 patients by MRI（2 with enhanced scan）,and 2 patients were examined by both CT and MRI.Results：Of the 13 patients,the tumors were located in ends of long bone in 11 cases,diaphysis in 1 case,ilium in 1 case.The imaging appearance on the CT were osteolytic bone destructions,of which 6 cases with sclerotic margins,7 cases with different crest at destruction,1 case with fibrous reaction.MRI showed iso-hypointensity on T1-weighted image and mixed hyperintensity on T2-weighted image.The extraosseous soft tissue masses were observed in all cases,MRI showed iso-or iso-hypointensity on T1-weighted image and iso-hyperintensity or mixed hyperintensity on T2-weighted image.Heterogeneous enhancement was found within the lesions.Conclusion：The primary BMFH have certain imaging features on CT and MRI,may be demonstrate the pathological features,are very valuable in the diagnosis of the disease before operation.