侵袭性纤维瘤病CT表现及鉴别诊断

CT Features and Differential Diagnosis of Aggressive Fibromatosis

目的分析侵袭性纤维瘤病的CT表现,以提高对本病的认识及诊断水平。资料与方法回顾性分析21例经病理证实的侵袭性纤维瘤病的CT表现,21例均行CT平扫,18例行增强扫描。结果 21例中,腹内7例(肠系膜5例,腹膜后及腹腔各1例),腹壁7例(腹直肌2例,腹内斜肌5例),腹外7例(胸壁3例,颌骨、骶骨、颈部及大腿软组织各1例)。骨外侵袭性纤维瘤病19例,12例为类圆形或梭形,7例为不规则形。CT平扫示17例肿瘤密度为等或略低于肌肉密度,2例肿瘤为囊实性;增强扫描17例中,15例肿瘤为轻中度强化,2例肿瘤明显强化,4例肿瘤内见增强的血管影穿行。骨侵袭性纤维瘤病2例,CT平扫表现为轻度膨胀性骨质破坏,1例增强扫描肿瘤轻度强化。结论侵袭性纤维瘤病可分为腹壁、腹内及腹外三型,各型CT表现具有一定特征性,根据发病部位不同需与其他肿瘤鉴别。

Purpose To analyze the CT findings of aggressive fibromatosis,and to improve the diagnostic accuracy.Materials and Methods CT findings of 21 cases of aggressive fibromatosis confirmed by pathology were reviewed.All 21 patients had preoperative precontrast CT scanning,and 18 cases had enhanced CT scan.Results Of 21 cases,7 cases had intra-abdominal tumors （5 in mesenteric,1 in retroperitoneal,and 1 intra-abdominal,respectively）,7 cases had tumors in the abdominal wall （2 in the rectus abdominis and 5 in the oblique internus abdominis）,and 7 had extraabdominal tumors （3 in the chest wall,1 in the maxillary bone,1 in the sacrum,1 in the neck and 1 in the thigh,respectively）.In the 19 cases of the extra-bone aggressive fibromatosis,the tumors were round or spindle shape in 12 cases,irregular in 7 cases.On precontrast CT images,17 cases showed equal or mild lower density than muscle,2 cases were cystic and solid.On enhanced CT images,15 cases showed mild to moderate enhancement,2 showed significantly enhancement,and 4 cases had visible enhanced vessels in the tumors.Two aggressive fibromatosis of the bone were expansive lytic and one showed mild enhancement.Conclusion Aggressive fibromatosis can be located in intra-abdominal,abdominal wall and extra-abdominal.They have certain CT characteristics and should be differentiated with other tumors. 更多