多模态影像学成像在骨恶性纤维组织细胞瘤诊疗中的应用

The Application of Multimodality Radiological Imaging in the Diagnosis and Treatment of Malignant Fibrous Histiocytoma of Bone

目的探讨多模态影像学成像在骨恶性纤维组织细胞瘤(MFHB)诊疗中的应用价值。方法选取2007年1月-2017年6月在我院就诊的并行影像学检查、经随访病理证实的16例原发性骨MFH患者为研究对象,其中男性10例,女性6例,分析其影像学资料。结果病灶分布在股骨7例,胫骨4例,髂骨1例,肱骨近端2例,桡骨远端1例,腰椎椎体1例。X线平片及CT表现:偏心性伴或不伴有膨胀性改变的骨质破坏,其中溶骨性10例(62.5%),混合性6例(37.5%)。5例(31.3%)病灶内有粗索条样或网格样巨大骨嵴。2例(12.5%)出现骨膜反应。MRI表现:16例(100.0%)病灶呈弥漫性异常混杂信号改变,T1WI呈等或略低信号,T2WI呈等或稍高信号,部分内可见斑片状及索条状低信号。结论 MFHB具有多样影像学表现及一定特征性,多模态影像学的联合应用有助于MFHB的诊断和鉴别诊断。

Objective To explore the application value of multimodality radiological imaging in the diagnosis and treatment of malignant fibrous histiocytoma of bone(MFH). Methods A total of 16 patients of primary MFH of bone which confirmed by pathologically in our hospital from January 2007 to June 2017 were reviewed. Among them, 10 cases were male and 6 were female. The imaging data of patients were analyzed retrospectively. Results In the total of 16 cases, 7 cases located in femur, 4 cases in tibia, 1 cases in ilium, 2 cases in proximal humerus, 1 cases in distal radius, 1 cases in lumbar body. Plain X-ray and CT findings: eccentric and with or without expansive bone destruction, in which 10 cases(62.5%) were osteolytic, 6(37.5%) cases were mixed. There were 5 cases(31.3%) with thick cord or mesh like huge bone crest. Periosteal reaction occurred in 2 cases(12.5%). MRI findings: In 16 cases(100%), the lesions were diffusely abnormal, mixed signals changed, T1 WI showed an equal or slightly lower signal, and T2 WI showed an equal or slightly higher signal, with patchy and bar like low signal in part lesions. Conclusion MFHB has a variety of imaging manifestations, but also has some specific characteristics to some extent. The combined utilization of multimodal radiological imaging is helpful for the diagnosis and differential diagnosis of MFHB.