MRI诊断隆凸性皮肤纤维肉瘤

Magnetic resonance imaging diagnosis of dermatofibrosarcoma protuberans

目的探讨隆凸性皮肤纤维肉瘤（DFSP）的MRI表现。方法收集经病理证实的8例DFSP患者,回顾性分析其MRI表现。结果 8例DFSP中,病灶位于躯干3例,四肢5例,均位于皮肤及皮肤下层,肿瘤最大径1.8~11.6 cm。T1WI示8例肿瘤呈等或略低于肌肉信号,T2WI示肿瘤呈明亮高信号,2例病灶内部见斑点状低信号;脂肪抑制（STIR）序列示6例肿瘤呈高信号;1例对比剂动力学时间分辨成像（TRICKS）动态增强MRA示肿瘤的供血血管为腓动脉。6例接受增强扫描者病灶均明显强化,2例病灶内见斑点状无强化出血区。结论 DFSP好发于四肢、躯干及头颈部皮肤及皮下组织,其MRI表现具有一定特征性。

Objective To investigate the MRI appearances of dermatofibrosarcoma protuberans（DFSP）.Methods MRI appearances of 8 patients with DFSP proved by operation and pathology were reviewed.Results Tumors located in skin and superficial fascia of the trunk（n=3） or limbs（n=5）.The maximum diameters of the tumors were 1.8—11.6 cm.Compared with the signal of muscles,DFSP presented intermediate or slight hypointensity on T1WI and brightly high signal on T2WI,and patchy hypointensities were detected in 2 cases on T2WI.High signal intensity on short time inversion recovery（STIR） images was noticed in 6 cases.Time resolved imaging of contrast kinetics（TRICKS） MRA showed the feeding artery of DFSP was peroneal artery in one patient.In patients underwent contrast enhanced MR imaging,conspicuous enhancement occurred in all 6 DFSP,and 2 of them showed heterogeneous enhancement for hemorrhage.Conclusion Skin and superficial fascia of the trunk,limbs,head and neck are common sites of DFSP,which has characteristic MRI appearances.