软骨黏液样纤维瘤的影像学表现

Imaging findings of chondromyxoid fibroma

目的:分析软骨黏液样纤维瘤的影像表现及诊断要点,提高对该病的诊断准确率。方法:回顾性收集32例经手术病理确诊为软骨黏液样纤维瘤患者的临床资料及影像学表现,并复习相关文献。结果:32例中,病变位于管状骨23例、扁骨8例、不规则骨1例。术后复发2例,术后诊断为恶变1例。32例均行X线及CT平扫,18例行MRI平扫及增强扫描。X线及CT典型表现为干骺端偏心性溶骨性骨质破坏,边界清楚,部分有轻度硬化边,钙化1例,复发2例和恶变1例可见骨膜反应,余骨皮质表面均未见骨膜反应。MRI表现为T_(1)WI呈等、稍低信号,脂肪抑制T_(2)WI呈稍高、高信号,增强扫描呈轻中度强化。结论:软骨黏液样纤维瘤是一种罕见的良性骨肿瘤,常见于长骨干骺端,很少有钙化及骨膜反应,综合分析其影像特点,可提高对该病的诊断水平。

Objective:To analyze the imaging manifestations and diagnostic points of chondromyxoid fibroma,improve the diagnostic accuracy of the disease.Methods:The clinical data and imaging findings of 32 patients with chondromyxoid fibroma diagnosed by operation and pathology were analyzed retrospectively,and the relevant literatures were reviewed.Results:Among 32 cases,23 lesions located in tubular bone,8 in flat bone and 1 in irregular bone.Postoperative recurrence occurred in 2 cases,and malignant transformation was diagnosed in 1 case.X-ray and CT were performed in 32 cases,and plain and enhanced MRI were performed in 18 cases.On the typical X-ray and CT images,the lesions showed eccentric osteolytic bone destruction of the metaphysis,with clear boundaries,some with thin sclerotic margins,and only 1 case had calcification,2 cases with recurrence and 1 case with malignant transformation had the periosteal reaction.MRI showed isointensity and hypointensity on T_(1)WI,hyperintensity and slight hyperintensity on T_(2)WI fat suppression,and mild or moderate enhancement.Conclusions:Chondromyxoid fibroma is a rare benign bone tumor that is common in the bone destruction of the metaphysis in the long bone,with little calcification and periosteal reaction.Comprehensive analysis of its imaging characteristics is needed to improve the diagnostic accuracy of the disease.