隆突性皮肤纤维肉瘤的CT及MRI表现

CT and MRI features of dermatofibrosarcoma protuberans

目的探讨隆突性皮肤纤维肉瘤(DFSP)的CT及MRI征象。方法回顾分析16例经手术病理结果证实的DFSP的影像资料(11例接受CT检查,5例接受MR检查),分析肿瘤的形态、CT及MRI特征。结果 DFSP多发于躯干及头颈部皮肤,呈不同程度隆起于皮肤表面,部分悬吊于皮外。16例中,结节肿块型12例、弥漫型4例。CT上肿块呈与肌肉等密度或稍低密度的实性占位,MRI上T1WI呈等/低信号,T2WI为稍高信号。肿瘤血供较丰富,增强扫描多呈渐进性中度至明显强化。病灶内征象包括"悬吊征"2例,"皮肤尾征"6例,"筋膜尾征"1例,"脂肪尾征"4例。结论 DFSP多表现为皮肤及皮下结节肿块型或弥漫生长型实性病变,不同形态其征象不同,但仍具有一定的特征性。

Objective To investigate CT and MRI features of dermatofibrosarcoma protuberans （DFSP）. Methods Totally 16 patients with DFSP confirmed by pathology were enrolled. Tumor morphology, CT and MRI imaging appearance （11 cases underwent plain and enhanced CT, 5 cases underwent plain and enhanced MRI） were analyzed retrospectively. Results DFSP usually occurred in the skin of truck, head and neck, protruding from the skin surface in different extent. Some lesions even suspended out of the skin. The lesions were divided into nodular type （n=12） and diffuse type （n=4） according to their morphological appearance. The tumors usually demonstrated as iso-density or slightly low density solid mass compared to muscle on CT. On MRI, it usually demonstrated as low signal on T1WI and high signal on T2WI. Tumor blood supply was rich, and it usually showed progressively moderate to strong enhancement. The signs within DFSP include ＂hanging sign＂ （n=2）, ＂skin tail sign＂ （n=6）, ＂fascia tail sign＂ （n=1）, ＂fat tail sign＂ （n=4）. Conclusion DFSP can be characterized by nodular or diffuse lesions, the manifestations of different form are slightly different, but still have a certain characteristic.