14例骨良性纤维组织细胞瘤的X线、CT及MRI表现分析

Pathological features and X-ray,CT and MRI analysis of benign fibrous histiocytoma

目的观察分析骨良性纤维组织细胞瘤(benign fibrous histiocytoma,BFH)的影像表现。方法回顾性分析经手术及病理证实的14例BFH患者影像表现,并与病理进行对照。其中行X线检查7例,行CT检查10例,行MRI检查7例。结果14例BFH均为发生于长骨的单发病灶,其中胫骨6例,股骨5例,腓骨1例,肱骨2例。X线表现为溶骨性骨质破坏,呈偏心性改变,边界清晰,骨皮质变薄,有不同程度的硬化缘,病灶均未见骨膜反应。CT表现为骨质破坏区软组织密度灶,硬化边明显,常表现为花边样,可不连续,CT值与邻近肌肉相似,未见骨膜反应及软组织肿块。MRI病灶T1WI为等低信号,T2WI为混杂高信号。结论骨BFH的影像表现为主要位于髓腔内的偏心性、膨胀性骨质破坏,硬化边可不连续,结合影像学特征有利于骨BFH的准确诊断及鉴别诊断。

Objective To explore the imaging features of benign fibrous histiocytoma(BFH)of bones to the diagnostic level.Methods Imaging findings of 14 patients with BFH proved pathologically were the retrospectively analyzed.X-ray plain film was obtained in 7 patients,10 patients were followed CT scanning,and 7 patients were followed MR.Results All lesions of 14 patients appeared as solitary.BFH occurred in the tibia(6 patients),femur(5 patients),fibula(1 patient),humerus(2 patients).On X-rays,the lesions appeared aslytic,eccentric and clear boundary with a thinning and a different degree sclerotic rim of the cortex.The tumor was without a periosteal reaction.The CT manifests as a soft tissue density lesion in the bone destruction zone,with hardened edges,and often presents with a lace-like appearance,which may be discontinuous.CT showed the lesions with a soft-tissue density similar to that of the adjacent muscle.The lesions were also without soft tissue reaction and mass.The lesions on MR showed a hypo to isointense on T1WI and a hybrid high signal on T2WI.Conclusions The BFH imaging of bones is characterized by eccentricity and expansive bone destruction mainly in the medullary cavity,and the hardened edges may be discontinuous.The combination of its characteristics is beneficial to the accurate diagnosis and differential diagnosis of the disease.