韧带样型纤维瘤的影像学特征

Image Findings of Desmoid Type Fibromatoses

目的探讨韧带样型纤维瘤(desmoid-type fibromatoses,DF)的影像学特征。方法回顾性分析经手术及病理证实的20例DF患者的影像和临床资料,其中原发性DF 13例,复发性7例。探讨其CT和MRI影像学特征。结果 20例DF均单发,其中12例(60.0%)边界不清,9例(45.0%)包绕血管神经,8例(40.0%)有骨膜粘连。10例行CT检查,平扫呈稍低密度,密度均匀,瘤内未见钙化及坏死区。增强扫描6例表现为中度强化,延迟扫描5例呈渐进性强化。15例行MRI检查,T1WI呈等或稍低信号,T2WI呈高于肌肉低于脂肪信号,增强扫描11例呈中等或明显不均匀强化,并随着各期相渐进性强化。其中9例(81.8%)可见条索状或小斑片状T1WI及T2WI低信号,增强后未见强化。扩散加权成像(DWI)扫描2例呈高信号,表观扩散系数(ADC)图上呈等或稍高于肌肉信号。结论 DF的CT、MRI表现具有一定特征,MR增强、动态增强及DWI扫描对DF的诊断及预后监测具有重要价值。

Objective To investigate the CT and MRI findings of the desmoid type fibromatoses（DF）.Methods Clinical features and image characteristics of 20 patients with DF proved surgically and pathologically were analyzed retrospectively.Results 20 cases of DF were single,12（60.0%） tumors showed ill defined margin.Neurovascular involvement was detected in 9 tumors（45.0%）,and periosteal adhesion was seen in 8 tumors（40.0%） lesions.CT scan was performed in 10 patients.Plain CT showed slightly hypodensity lesions without calcification and necrosis.Enhanced CT scan was performed in 6 patients,all tumors showed moderate enhancement.Delayed enhanced CT scan was performed in 5 cases,5 cases appeared progressing enhancement.MR scan was performed in 15 patients.All cases appeared iso or slightly hypointensity on T1WI and hyperintensity on T2WI.The enhanced MR was performed in 11 cases.All cases appeared heterogeneous moderate or obvious gradual enhancement.The band area of low signal intensity on both T1WI and T2WI without enhancement was detected in 9（81.8%） lesions.Hyperintensity signal was seen on DWI in 2 cases,and hyperintensity similar to or slightly higher than the muscle on ADC maps could be revealed.Conclusion DF has certain CT and MRI characteristics.The post contrast MR and DWI are helpful in diagnosis and monitor after operation.