低度恶性肌纤维母细胞肉瘤的影像学分析

Imaging Analysis of Low Grade Myofibroblastic Sarcoma

目的探讨低度恶性肌纤维母细胞肉瘤(LGMS)的影像特点及提高其影像诊断水平。方法回顾性分析8例经病理证实的LGMS的X线、CT、MRI表现。单种方法检查中,行X线平片检查1例,行CT及MRI检查各2例;3例行2种方法检查。结果 8例LGMS中,5例发生于软组织,3例发生在长骨;发生于软组织者,在CT上2例边界较清晰,2例可见大量不规则钙化影,3例行增强扫描,动脉期肿瘤均呈明显不均匀强化,仅有1例行静脉期扫描,肿瘤强化程度进一步增高,1例出现双肺转移,在MRI上,肿瘤呈长T1、长T2信号,增强扫描瘤体强化明显;发生于长骨者,在X线平片上呈斑片状、虫蚀样的溶骨性骨质破坏,未见硬化边、钙化及骨膜反应,在MRI上,肿瘤呈长T1、长T2信号,增强扫描肿瘤以外周强化明显,肿瘤中心区域未见强化。结论 LGMS发病率低,影像表现缺乏特征性,确诊需依靠病理检查。

Objective To discuss imaging features of low grade myofibroblastic sarcoma and improve its diagnostic ca- pacity. Methods A retrospective analysis was made on plain film, CT and MRI of 8 cases with pathologically approved low grade myofibroblastic sarcoma. Results In the 8 cases of low grade myofibroblastic sarcoma, 5 cases occurred in soft tissue, 3 cases in long bones ; 3 cases had relatively distinct boundary on CT in soft tissue, 2 cases of them showed a great deal of irregular calcification, which were obviously heterogeneous enchanced in arterial phase, only one was more obvious- ly enhanced in venous phase. Tumors showed long T1 , long T2 signals on MRI, and were markedly enhanced. 3 cases in long bones presented as patching, worm eaten destruction of bone, and sclerosis edge, calcification and periosteal reaction were not be seen in them, which showed long TI , long T2 signals on MRI, and obvious enhancement could be found around tumour, there was no enhancement in central region of tumour. Conclusion Low grade myofibroblastic sarcoma is a dis- ease of low incidence, and has no imaging features, the final diagnosis depends on patholozical results..