长骨良性纤维组织细胞瘤的影像表现

Imaging features of benign fibrous histiocytoma of long bones

目的分析骨良性纤维组织细胞瘤(BFH)的影像表现。方法经手术病理证实的9例BFH患者均接受X线检查,且其中4例接受MR平扫及增强扫描,4例接受CT检查。结果 9例BFH均为位于下肢的单发病灶,其中胫骨5例,股骨3例,腓骨1例。X线片均表现为偏心溶骨性骨破坏区,边界清晰,骨皮质变薄,可有不同程度的硬化缘;CT平扫显示骨质破坏区为与肌肉密度相仿的软组织密度影,2例病灶位于膨胀的骨壳内,2例位于胫骨的病灶穿破骨皮质,未见软组织肿块;所有病灶均未见骨膜反应。病灶T1WI呈等低信号,T2WI呈混杂高信号,增强MRI呈均匀或不均匀中度或明显强化。结论长骨BFH的影像表现可为临床诊断提供依据。

Objective To explore the imaging features of benign fibrous histiocytoma（BFH） of long bones.Methods Imaging findings of 9 patients with BFH proved pathologically were retrospectively analyzed.X-ray plain film were obtained in all patients,and 4 patients underwent MR,4 patients underwent CT scanning.Results All lesions appeared as solitary.BFH occurred in the tibia（5 patients）,femur（3 patients）,fibula（1 patients）.X-ray showed osteolytic lesions with eccentric thinning of the cortex.Sclerosis was found in the margin of the lesions to variable extent.CT revealed dense soft tissue in the lesions.Two lesions were restricted to bone,2 tibia lesions destroyed the cortex but soft tissue mass did not form.Periosteal reaction was not found in alll lesions.MRI manifestations included a hypo to isointense lesion on T1WI and hyperintense signal intensity on T2WI.There was homogeneous or heterogeneous moderate to significant enhancement of the tumor after administration of contrast medium.Conclusion Imaging features of BFH in long bones can provide clues for clinical diagnosis.