四肢长骨良性纤维组织细胞瘤的X线平片及MRI特征

X-ray Film and MRI Features of Benign Fibroushistiocytoma in the Extremities

目的探讨四肢长骨良性纤维组织细胞瘤(BFH)X线平片及MRI的影像特点及提高其影像诊断水平。方法回顾性分析9例经病理证实四肢长骨BFH患者的X线平片及MRI表现,所有病例均行X线平片检查,其中3例行MRI检查。结果 9例BFH均呈囊状膨胀性骨质破坏,位于骨干者以纵向中心性膨胀为著,位于骨端关节面下者以横向偏心性膨胀破坏为著,所有病例边界清晰,2例病灶内呈较均匀低密度影,1例病灶内似见斑点状密度增高影,6例呈磨玻璃样密度,瘤内见不规则条状分隔,7例见间断性硬化边,1例可见层状骨膜增生。MRI中,2例呈长T1、长T2信号;1例呈多囊状,囊性部分呈等T1、长T2信号,病灶下部呈等T1、等T2信号,在T2WI中见大量线状低信号分隔;3例周围均见长T1、短T2的硬化环;Gd-DTPA增强扫描,肿瘤实性部分及线状分隔明显强化。结论四肢长骨BFH影像表现具有一定特征,综合分析其像学及临床资料能够提高诊断准确性。

Objective To explore X ray film and MRI features of benign fibroushistiocytoma of the extremities and improve its diagnostic accuracy.Methods A retrospective analysis was made on X ray film and MRI of 9 cases with pathologically approved benign fibroushistiocytoma in the extremities.X-ray examination was performed in all cases and MRI in 3 cases.Results 9 cases showed cystic expansive osteolytic lesions,BFH was located in the diaphysis with longitudinal center expansion bone destruction,located at metaphysis and epiphysis with transverse eccentric expansion damage,all cases had clear border in the bone,2 cases presented uniformly low density in the lesion,1 case with invisible speckle density increased shadow,6 cases showed ground glass density with irregular strip separator,7 cases showed discontinuous sclerosis edge,1 case appeared lamellar periosteal proliferation.On MRI,2 cases showed long T1 and T2 signal intensity;1 case showed a multilocular cystic part with equal T1 and long T2 signal intensity,lower part of tumor was equal T1 and T2 signal intensity,a large number of linear low signal separation shadow could be found in T2WI;3 cases were presented around the long T1 short T2 sclerotic ring;solid part of tumor and linear separator were obviously enhanced.Conclusion There are certain image characteristics in benign fibroushistiocytoma in the extremities,a comprehensive analysis of the imaging and clinical data can improve the diagnostic accuracy.