腹壁外韧带样瘤MRI诊断探讨

MRI diagnosis of the extraabdom desmoid tumor

目的讨论腹壁外韧带样瘤的MRI平扫及增强扫描的表现,评价MRI对该病的诊断价值。方法回顾分析5例经手术切除及病理证实的腹壁外韧带样瘤的术前MRI平扫及增强扫描表现,其中2例同时行CT平扫,3例同时行血管造影。结果5例腹壁外韧带样瘤均位于四肢肌肉及软组织,年龄11岁～28岁,其病灶MRI表现为在T1WI上,肿物呈中等信号,其间可见条片状及斑点状低信号,在T2WI上则呈高信号,其间夹杂中等、稍低及更低的条片状、斑点状信号,后者与在T1WI上所见的低信号相吻合。增强扫描后在平扫中呈等T1、长T2或长T1、长T2信号改变的区域均强化非常明显,而在T1WI及T2WI上均呈条片状、斑点状低信号区域则未见强化,5例病灶周围组织均未见水肿,3例邻近骨出现压迫性改变,2例CT显示病灶密度欠均匀,边界清晰,3例血管造影可见肿瘤染色明显。结论MRI可以较为精确的显示腹壁外韧带样瘤的病灶形态及范围,对韧带样瘤的诊断与鉴别诊断有重要价值,是目前最好的影像学检查方法。

Objective To discuss MRI feature of the extraabdom desmoid tumor on unenhanced and enhanced MRI scans and to evaluate the value of MRI in diagnosing this disease.Methods We reviewed the feature of 5 cases of the extraabdom desmoid tumor which had been confirm by pathology.2 cases were examined by plain CT scans,3 cases were examined by DSA.Results 5 cases all located at the muscles of limbs,age from 11 to 28,variable signal was demonstrated,the main parts of the tumor was medium or low signal on T1WI and high signal on T2WI,some parts of the tumor were low signal on both T1WI and T2WI.On MRI enhancement scan,the main parts of medium or low signal on T1WI and high signal on T2WI distinctly enhanced,the parts low signal on both T1WI and T2WI can not be see enhancement.Round the tumor of 5 cases,it can not be see distinct edema.On 3 cases,the neighbor bone was be pressed.The CT manifestations of 2 cases,the tumor showed slightly mixed density,tumor stain was found in 3 cases by DSA.Conclusion MRI can accuracy delineating the site,shape and extent of the extraabdom desmoid tumor.MRI is valuable in detecting and differentiating of the desmoid tumor and MRI is the best method of medical imaging. [