软组织恶性纤维组织细胞瘤影像诊断与鉴别诊断

目的探讨经手术和病理确诊的软组织恶性纤维组织细胞瘤的CT和MRI特点。方法回顾分析山东省菏泽市立医院放射科2008~2013年经手术和病理确诊的21例软组织恶性纤维组织细胞瘤患者。CT扫描17例,MRI扫描2例,CT和MRI扫描2例。平扫16例,CT增强2例,MRI增强2例,CT和MRI均增强者1例。结果 21例软组织恶性纤维组织细胞瘤患者中发生于下肢12例,上肢5例,胸骨和胸壁2例,肾脏1例,盆腔1例。其中上下肢发病率最高,占81%。不规则分叶状17例,规则类圆形4例,其中,不规则分叶状比例最高,占81%。21例中伴囊变坏死者5例,占24%。5例增强扫描病例中,均可见早期不均匀明显强化。结论软组织恶性纤维组织细胞瘤的临床和影像学特点具有相对特征性,充分认识其特征,有助于提高术前诊断正确率。

Objective To discuss the CT and MRI features of malignant ifbrohistiosarcoma of soft tissue conifrmed by operation and pathology. Methods 21 cases from 200 to 2013 in the radiology department of our hospital were reviewed. 17 cases scanned with CT, 2 cases scanned with MRI, 2 cases scanned with CT and MRI. 16 cases scanned with CT pre-contrast, and 2 cases used CT post contrast, 2 cases used MRI post contrast, 1 case scanned with CT and MRI post contrast. Results 12 cases occurred in the lower limbs, 5 cases upper limbs, 2 cases of sternum and chest wall, 1 case kidney, 1 case pelvic. The upper and lower limbs accounting for 81%. Irregular and lobulated mass 17 cases, accounted for 81%, roundly mass 4 cases, Masses with deterioration were found in 5 patients, accounted for 24%. 5 cases of post contrast enhanced unequally and early. Conclusion The clinical and imaging of malignant ifbrohistiosarcoma of soft tissue are relatively characteristic, fully understand its characteristics, will help to improve the accuracy rate of preoperative diagnosis.