隆突性皮肤纤维肉瘤磁共振影像特征分析

Magnetic resonance imaging features of dermatofibrosarcoma protuberans

目的通过对14例隆突性皮肤纤维肉瘤(DFSP)的磁共振影像进行分析, 提高对DFSP磁共振影像特征的认识。方法本文为描述性研究。收集广东医科大学附属医院2011年3月至2022年6月经病理及免疫组化检测确诊的14例DFSP患者的磁共振影像资料, 分析DFSP磁共振影像特征情况, 包括T1加权成像(T1WI)、T2加权成像(T2WI)、弥散加权成像(DWI)、增强扫描等序列影像特征。结果 14例DFSP患者中, 男9例、女5例, 年龄21~58(43.8±12.2)岁。14例均为单发, 表现为突出皮肤表面的结节/肿块, 最大长径21~160(57.1±37.0)mm, 平均体积大小为57.1 mm×40.4 mm×28.4 mm。DFSP平扫T1WI信号与肌肉相仿, T2WI高信号, 6例病灶内可见少量线状低信号分隔, 3例DWI呈明显高信号, 10例增强扫描病灶呈明显均匀强化, 4例呈不均匀强化, 内可见斑片低强化区域。6例病灶内T2WI压脂低信号分隔增强扫描强化不明显。1例肿块内可见流空血管影。1例肿块内可见出血信号, T1WI平扫呈高信号。14例病灶局限在皮肤及皮下脂肪组织内, 5例出现脂肪尾征, 4例出现筋膜尾征。14例病灶与深层周围结构分界清楚, 未见邻近深层结构受侵犯改变。结论 DFSP局限在皮肤及皮下脂肪组织内, 磁共振平扫及增强扫描有一定的影像特征, 正确认识影像征象有助于提高对DFSP的认识, 为DFSP的病理诊断及临床诊治提供有用的参考。

Objective To improve the understanding on the magnetic resonance imaging(MRI)features of dermatofibrosarcoma protuberans(DFSP)by analyzing the MRI features of 14 cases of DFSP.Methods It was a descriptive study.The MRI data of 14 patients with DFSP diagnosed by pathology and immunohistochemistry in Affiliated Hospital of Guangdong Medical University from March 2011 to June 2022 were collected,and the MRI characteristics of DFSP were analyzed,including the imaging characteristics of T1 weighted imaging(T1WI),T2 weighted imaging(T2WI),diffusion weighted imaging(DWI),and enhanced scanning sequences.Results Among the 14 cases of DFSP,9 cases were male and 5 cases were female.The age ranged from 21 to 58 years old,with an average age of(43.8±12.2)years old.All the 14 cases were single,manifested as nodules/masses protruding from the skin surface,with a maximum length of 21-160 mm and an average of(57.1±37.0)mm,with an average volume of 57.1 mm×40.4 mm×28.4 mm.The signal of unenhanced T1WI was similar to that of muscle,with high signal on T2WI.A few linear low-signal separations were seen in 6 cases.Three cases showed obvious high signal on DWI.Ten cases showed obvious uniform enhancement,but 4 cases showed uneven enhancement,and patchy low enhancement was seen in the lesions.In 6 cases,there was no obvious enhancement on low lipemia T2WI.In 1 case,a flow vacant vascular shadow was seen in the mass.In 1 case,hemorrhagic signal was seen in the mass,which showed high signal on T1WI plain scan.The lesions were confined to the skin and subcutaneous adipose tissue in 14 cases,with fat tail sign in 5 cases and fascia tail sign in 4 cases.The demarcation between the lesions and the deep surrounding structures was clear in 14 cases,and there was no invasion to adjacent deep structures.Conclusions DFSP is confined to the skin and subcutaneous adipose tissue.MR plain and enhanced scans have certain imaging features.Correctly understanding these imaging features helps to improve the understanding on DFSP,which is helpful for the pathological diagnosis and clinical diagnosis and treatment.