四肢软组织成人型纤维肉瘤的MRI征象分析

MRI Appearance of Soft Tissue Adult Fibrosarcoma in Extremities

目的探讨四肢软组织成人型纤维肉瘤的MR I表现。资料与方法回顾性分析经病理证实的四肢软组织成人型纤维肉瘤8例,总结其MR I特征。结果 8例成人型纤维肉瘤共18个瘤灶,其中单发6例,多发2例(12个瘤灶)。瘤灶呈分叶状7例(17个病灶),类圆形1例(1个病灶)。肿瘤最大者直径10.3 cm,最小者1.2 cm,平均5.8 cm。位于深筋膜下方7例(17个病灶),其中10个贴近深筋膜生长并见结节状突起,1例(2个病灶)突破深筋膜向外生长;位于肌肉间隙1例(1个病灶)。MR I平扫病灶主体T1W I呈低等信号,T2W I呈脑回状混杂信号;7例(17个病灶)伴周围肌肉水肿,3例(6个病灶)见囊变、坏死,1例(1个病灶)侵犯邻近骨质。4例增强扫描共13个病灶呈明显边缘性或"轮辐"状强化。结论 MR I能精确地显示病灶的组织结构、形态、范围,对肿瘤的诊断和鉴别诊断及分期有重要价值。

Objective To investigate MRI features of soft tissue adult fibrosarcoma in extremities.Materials and Methods The MRI features of 8 cases with soft tissue adult fibrosarcoma in the extremities confirmed by pathology were retrospectively reviewed.Results There were 18 tumor lesions in 8 patients.6 patients with solitary lesion and 2 cases with multiple lesions.17 lesions were lobulated and another one was oval round in shape.The sizes of the lesions in diameter were from 1.2 cm to 10.3 cm,average 5.8 cm.7 cases with 17 lesions located under the deep fascia.10 of the 17 lesions were adjacent to the deep fascia with nodular-like protrution.1 case with 2 lesions broken through the deep fascia.The other one located in the space of muscle interval.All the lesions showed hypointense to isointense signal on T1WI and heterogeneous gyri-like signal on T2WI.7 cases with 17 lesions showed edema signal in surrounding muscles.3 cases with 6 lesions showed cystic or necrosis area.1 case involved the adjacent bone.4 cases with 13 lesions on gadolinium contrasted MRI showed peripheral or spoke-like enhancement.Conclusion MRI is an accurate method in delineating the histologic composition,shape and extent of the lesion,and is valuable in detecting,differentiating and staging soft tissue adult fibrosarcoma.