隆突性皮肤纤维肉瘤的影像诊断价值

The value of imaging diagnosis of dermatofibrosarcoma protuberans before surgery

目的探讨隆突性皮肤纤维肉瘤的影像学表现。方法收集经手术病理证实的隆突性皮肤纤维肉瘤患者13例,行CT及MR检查,分析其影像学表现特征。结果13例患者中,肿块位于躯干10例,头颈3例。单发12例,多发1例。肿块形态呈类圆形或结节状,最大径0.8~5.8cm,与皮肤界限欠清,肿块较大时可向周围脂肪间隙内浸润。CT平扫呈低于肌肉的均匀软组织密度,未见坏死、出血、囊变及钙化,增强后肿块明显不均匀强化。MRI平扫T1WI呈均匀低信号,T2WI+fs及STIR呈不均匀高信号,DWI呈高信号。结论隆突性皮肤纤维肉瘤具有影像学特点,术前检查能为临床治疗提供参考。

Objective To explore the imaging features of dematofibrosarcoma protuberans so as to improve the accuracy of diagnosis before surgery.Methods We retrospectively analyzed 13 cases of dematofibrosarcoma protuberans comfirmed by pathology,via collecting their clinical,imaging and pathological data.Results 13 patients were recruited,in whom 9 were male and 4 were female,with age ranging from 34 to 53 years old(the median age was 48 years old).The course of disease was between 0.6 and 20 years(the median time was 7 years).Single mass was found in 12 cases,and multiple masses was found in 1 case,with 10 cases in trunk and 3 cases in head and neck.All the masses manifested oval or nodule shape,unclear boundary with skin and fat infiltration sign that could be seen in bigger mass.The masses were homogeneous soft tissue density(attenuation lower than muscle)without necrosis,hemorrhage,cystic and calcification.The masses showed heterogeneous enhancement after intravenous injection of contrast agent.MRI revealed homogeneous hypointense signal on T1WI,heterogeneous hyperintense signal on T2WI+fs and STIR,DWI showed restricted signal.Conclusion Some imaging characteristic features of dermatofibrosarcoma protuberans could be found before surgery and imaging examination could contribute to lowering the relapse rate.