四肢黏液样脂肪肉瘤CT、MR表现与病理相关分析

Correlation of CT,MR features with pathologic findings in myxoid liposarcoma of the extremities

目的探讨四肢黏液样脂肪肉瘤CT、MR表现与其病理结构的关系,提高CT及MR诊断本病的准确率。方法对10例病理已证实的黏液样脂肪肉瘤患者的CT和(或)MR征象进行观察、分析并记录,与其组织标本病理改变进行对比分析。结果 10例均位于下肢,其中7例发生在大腿,3例发生在小腿。6例病变呈囊状液性密度(或信号),4例病变呈囊实性密度(或信号)。CT和(或)MR平扫呈囊状液性密度/信号的成分,在病理上对应为黏液样间质;病变实性部分在病理上对应的是肿瘤细胞密集区。行MR检查的8例病变中,4例可见"线"样、"花边"状或"云絮"状短T1WI信号,病理上对应为黏液基质内不同阶段的不成熟脂肪细胞。结论黏液样脂肪肉瘤CT、MR表现与其组织病理改变密切相关,熟悉其病理学表现对影像学做出正确诊断至关重要。

Objective To investigate the relationship between CT,MR features and pathologic findings in myxoid liposarcoma of the extremities in order to improve its diagnostic accuracy by CT and MR. Methods The CT and（or） MR findings in 10 cases of myxoid liposarcoma of the extremities were retrospectively defined,observed,recorded and compared with their own pathologic findings. Results All 10 cases were located in the lower limbs,of which 7 occurred in thigh and 3 occurred in crus. 6 cases showed cystic-fluid density（signal）,and 4 showed solid-cystic density（signal）. The lesions showed cystic-fluid density/signal on CT or MR,which corresponded to myxoid stroma in pathology. The lesions showed solid density/signal owing to the tumor cells concentrated area,of which 4 cases had＂line＂,＂lacy＂or＂clouds-like＂of high signal intensity on T1 WI,which corresponded to immature adipocytes at different stages. Conclusion The expression of CT,MR in MLS is closely related to the histopathological changes,and familiarity with its pathological findings is essential to correct diagnosis of imaging.