软组织恶性纤维组织细胞瘤的MRI特征与病理分析

MRI findings and pathologic analysis of soft-tissue malignant fibrous histiocytoma

目的探讨软组织内恶性纤维组织细胞瘤的MRI表现及病理特征,以提高影像诊断水平。方法回顾性分析经手术病理证实的12例软组织内恶性纤维组织细胞瘤患者的MRI影像及病理资料。结果 12例肿瘤形态多变,以梭形、类圆形及分叶状多见。12例中8例T1WI呈稍低信号或等信号,4例呈混杂信号;T2WI均呈混杂高信号,7例肿瘤内可见低信号分隔影,5例肿瘤可见假包膜,6例肿瘤边界不清,可见瘤周水肿。MRI增强后肿瘤呈明显不均匀强化。病理上肿瘤组织成分复杂,主要由纤维母细胞和组织细胞组成,质软,境界较清,可有假包膜。9例可见坏死或黏液样变,4例伴出血。结论恶性纤维组织细胞瘤的MRI表现与病理特征密切相关。该肿瘤的组织学成分复杂,因此MRI信号多变,其中MRI在病灶定位、出血及坏死囊变方面更具优势,对软组织恶性纤维组织细胞瘤的诊断具有重要价值。

Objective To study the MRI findings and pathological features of the soft-tissue malignant fibrous histio- cytoma （MFH） in order to improve diagnostic level. Methods The MRI imaging and pathological data of 12 MFH cases confirmed by surgery were analyzed retrospectively. Results Twelve MFH cases showed changeful morphology with fusiform, circular and lobulated shape. 8 MFH cases showed slightly low signal or equal signal intensities and 4 cases showed mixed signal intensities on T1WI. All cases showed high mixed signal intensities on T2WI. Low signal intensi- ty septum structure was found in 7 cases. False capsule were seen in 5 cases. Tumor boundary of 6 cases was not clear with edema round. All lesions showed significantly uneven enhancement. Tumor composition was complex with soft mass, clear boundary and false capsule on pathology. It was mainly composed of fibroblasts and tissue cells. Necrosis or myxoid degeneration was seen in 9 patients, and 4 cases with bleedings were detected. Conclusion The MRI find ings and pathological features of malignant fibrous histiocytoma （MFH） are closely related. MRI signal is variable be- cause the tumor histological composition is complex. MRI examination has more advantages in lesion localization, hemorrhage, necrosis and. cystic change MRI shows important value in the diagnosis of MFH in soft tissue.