韧带样瘤的影像表现与病理分析

Imaging manifestations and pathological analysis of desmoid tumor

目的回顾性分析韧带样瘤的影像表现和病理学特征,提高对本病的术前诊断符合率。方法收集我院2011年1月以来,15例经病理证实为韧带样瘤的临床资料、影像学表现及病理特征,并对其影像学特征进行总结分析。结果 15例患者,女性10例,男性5例,中位年龄36岁。3例行CT平扫检查,4例行CT平扫及增强检查,7例CT均表现为局部软组织肿块,呈等低密度,3例密度均匀,4例密度欠均,4例边界清晰,3例边界不清,增强扫描3例均匀强化,1例明显不均匀强化。8例行MRI平扫及增强扫描检查,MR图像比较有特征,呈等T_1稍长或等T_2信号,压脂像呈高信号,部分内见条片状低信号,坏死囊变少见,增强扫描均有明显不均匀强化,其内条带状低信号无强化。上述病例3例复发,未见转移征象。结论韧带样瘤的影像学表现中,CT可以显示病灶的部位、大小、密度及与周围结构的关系,但是缺乏特征性表现;MRI检查T_1WI及T_2WI病灶内可见条带状低信号是其特征性表现,低信号区增强扫描无强化,掌握其影像特征,可以提高本病的诊断符合率。

Objective To retrospectively analyse of desmoid tumor imaging manifestation and pathological features of the disease, so as to improve the preoperative diagnosis rate. Methods A total of 15 cases pathologically proved desmoid tumor were collected in our hospital from January 2011. The clinical data, imaging findings and pathological features were analysised and summarized. Results A total of 15 patients （female 10 cases, male 5 cases, median age 35 years） under- went CT scan and MRI scan and enhanced scan, CT showed the local soft tissue mass in 7 cases, 4 cases with clear bound- ary, low density, unieven density, 3 cases with unclear boundary, uneven density, enhanced scan in 3 cases, 1 case was obviously inhomogeneous enhancement. 8 cases underwent routine MRI plain scan and enhanced scan. MR image had some characteristics, T1 showed low signal, T2 showed mixed signal, fat saturation showed high signal and internal showed low signal, cystic necrosis was rare, enhanced scan showed obvious heterogeneous enhancement, 3 cases of recurrence of the a- bove cases. There was no metastasis in 15 cases. Conclusion Among imaging of Desmoid tumor, CT can show the lesion site, size, density and relationship with the surrounding structures, but be lack of features~ MRI is more characteristic, It shows strip low signal in tumor lesions in the T1 WI and T2 W1, It can improve the diagnostic accordance rate of the disease if we master the imaging features.