腹部侵袭性纤维瘤病的CT及MRI特征

CT and MRI feaatures of abdominal aggresive fibromatosis

目的:探讨腹内侵袭性纤维瘤病的CT及MRI特征。方法:回顾性分析18例经手术病理证实的腹内侵袭性纤维瘤病CT及MRI表现。术前仅行CT检查9例,仅行MRI检查3例,同时行CT及MRI检查6例。结果:18例腹内侵袭性纤维瘤病表现为腹膜后或腹腔内软组织肿块。腹膜后肿块以浸润性生长呈不规则形、爪形多见;腹腔内肿块以膨胀性生长呈圆形、类圆形多见。CT检查15例中,平扫病灶呈稍低密度11例,等密度4例,病灶内未见坏死、钙化及脂肪密度,增强扫描动脉期病灶大部分呈不均匀轻度强化,静脉期病灶持续强化,延迟期强化最明显,其中9例病灶周边及内部残留有斑片状、条状无强化稍低密度区。MRI检查9例中,T2WI病灶均呈稍高信号;T1WI呈等信号5例,呈稍低信号4例;脂肪抑制T2WI序列,病灶呈明显高信号。其中6例病灶在各序列中均见有条带状致密胶原纤维形成的低信号影。动态增强扫描动脉期及静脉期病灶轻中度不均匀强化,延迟期病灶明显强化。结论:腹内侵袭性纤维瘤病的CT及MRI表现具有一定特征性,CT、MRI检查对该病有较高的诊断价值。

Objective：To investigate the CT and MRI appearances of abdominal aggresive fibromatosis.Methods：CT and MRI findings of 18 patients with abdominal aggresseive fibromatosis proved by pathology were analysed retrospectively.9 patients undrewent only CT scan,3 patients underwent only MRI examination,and 6 patients underwent both CT and MRI scans.Results：The 18 cases presented as masses in the retroperitoneum and in the peritoneal cavity.The masses in the retroperitoneum were mostly infiltrative and irregular,while the masses in the peritoneal cavity were mostly expansive and round or round-like in shape.On plain CT imaging,the lesions showed slightly low density in 11 cases,isodensity in 4 cases,there were no necrosis,calcification and fat in the lesion.On multi-phase contrast scan,enhancement was slight in arterial phase,continued in venous phase and intense in delayed phase,and in some area of the tumor there was no enahncemet in 9 cases.On MR imaging,there was slight hyper-intense on T2WI in all nine cases,isointense on T1WI in 5 cases and slight hypointense on T1WI in 4 cases.On fat-suppression T2WI the lesions showed marked hyper-intensity.In six of the nine cases there was streaky hypointense area in the lesion.On dynamic enhancement imaging,there was mild to moderate heterogenous enhancenment in arterial and venous phase,and intensive enhancement in delayed phase.Conlusion：The appearances of abdominal aggressive fibromatosis on CT and MRI were relatively characteristic,CT and MRI can be a valuable tool for the diagnosis of abdominal aggresive fibroomatosis.