骨良性纤维组织细胞瘤的影像表现

Imaging features of Benign fibrous histiocytoma of bone

目的 分析骨良性纤维组织细胞瘤（BFH）的影像表现,以提高影像诊断水平.方法 回顾性分析经手术病理证实的11例BFH的影像表现.全部患者均经X线检查,其中MR检查6例、CT检查4例.结果 11例BFH均为单发病灶,9例位于下肢,其中胫骨5例、股骨3例、腓骨1例；1例位于胸椎,1例位子骶骨.11例X线平片表现为偏心性（7例）或中心性（2例）溶骨性骨破坏区,边界清晰,薄层骨皮质完整,7例伴有不同程度的硬化边；4例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,3例位于膨胀的骨壳内,2例位于胫骨及1例位于胸椎的病灶穿破骨皮质,胸椎病灶形成软组织肿块；所有的病灶均未见骨膜反应.6例在MR T1WI呈等低信号,T2WI呈混杂高信号.增强扫描肿块呈均匀或不均匀中度或明显强化.结论 骨BFH的影像表现可为临床诊断提供依据.

Objective To evaluate the imaging features of benign fibrous histiocytoma （BFH）.Methods Imaging data were retrospectively collected and reviewed in 11 patients with pathologically proved BFH.Of the 11 patients,X-ray was performed in all patients,MR scans in 6 patients,and CT scans in 4 patients.Results ALL lesions detected were a solitary lesion.The distribution of BFH was in the tibia （n =5 ）,femur （ n =3）,fibula （ n =1 ）,sacrum （ n =1 ）,and thoracic vertebrae （ n =1 ）.X-ray features included eccentric osteolytic lesions in 7 patients and centric in 2 patients,with clear boundary and thinning of the cortex,and 7 patients with varying degrees of ossified border were found. CT scan shows bone destruction with density similar to soft tissue.The majority of lesions （ n =3 ） were observed in the expanding shell of bone,2 patients in the tibia and 1 patient in the thoracic lesions with cortical bone perforation.The thoracic lesion as soft tissue mass was detected. All of the lesions detected in CT showed no periosteal reaction.In patients with MR images,hypo to isointense signal intensity on T1WI and hyperintense signal intensity on T2WI was found. All lesions on post-contrast T1WI were detected with homogeneous or heterogeneous lesion with moderate or significant enhancement.Conclusion Imaging features were typical for MFH which is useful tool helping correct diagnosis of MFH.