侵袭性纤维瘤病的影像分析及组织病理学分析(1)
摘 要：目的 分析侵袭性纤维瘤病的影像特点，以及组织病理学特征。方法 回顾性分析2013年1月～2018年3月湖北省荆门市第一人民医院经术后病理证实的 15例AF患者的 CT 和 MRI表现，及MR与组织病理对照分析。结果 15 例患者全部行 CT 平扫，8例行CT增强；9例行 MRI平扫，6例行MRI增强。CT 平扫示13 例呈不均匀等、低密度，2 例呈较均匀稍低密度；12例边界不清，3例边界清楚；CT 增强8例均呈渐进性不均匀明显强化。MRI平扫提示T1WI、T2WI、压脂、DWI等序列肿瘤均为不均匀信号，夹杂不规则低信号，肿块边缘呈爪形浸润或边缘不清。MRI增强 6例均呈不均匀明显强化。结论 CT和MRI 都能从不同方面为AF的诊断提供信息，MRI能更好地显示肿瘤的形态、范围及边缘，且可推断肿瘤的大致成分，对AF的诊断更有帮助。
关键词：侵袭性纤维瘤病；CT及MR表现；组织病理学
中图分类号：R738.6 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.14.050
, http://www.100md.com
文章编号：1006-1959(2018)14-0161-03
Abstract：Objective To analyze the imaging features and histopathological features of aggressive fibromatosis.Methods Retrospective analysis of CT and MRI findings of 15 patients with AF confirmed by postoperative pathology in the First People's Hospital of Jingmen City，Hubei Province from January 2013 to March 2018，and a comparative analysis of MRI and histopathology.Results All the 15 cases underwent CT plain scan，8 cases of CT enhancement，9 cases underwent MRI plain scan，6 cases showed MRI enhancement，CT plain scan showed that 13 cases were uneven and low density，2 cases were more uniform and slightly lower density； 12 cases were unclear，3 cases were clear；8 cases of CT enhancement showed progressive inhomogeneity.MRI scan showed that the tumors of T1WI，T2WI，liposuction，DWI and other tumors were all inhomogeneous signals，with irregular and low signal inclusions，and the edges of the tumors were claw-shaped infiltrated or the edges were unclear.MRI enhancement in 6 cases showed uneven enhancement.Conclusion Both CT and MRI can provide information for the diagnosis of AF from different aspects.MRI can better display the shape，range and edge of the tumor，and can infer the general components of the tumor，which is more helpful for the diagnosis of AF.
, http://www.100md.com
Key words：Aggressive fibromtosis；CT and MRI findings；Histopathological
侵袭性纤维瘤病(aggressive fibromtosis，AF)是一种来源于软组织的纤维组织瘤样增生，呈侵袭性生长，有局部复发倾向，但不发生远处转移[1]。本病发生率为(2～5)/100万，好发于青中年人(25～45 岁为主)，少数发生于儿童及老年人[2]。本病影像精确诊断困难，术前对病灶的性质及与周围结构的关系描述常与术后不符，故本文回顾性分析经术后病理证实的 15 例AF 患者的CT及MRI表现，提高对本病的认识和诊断水平。
1资料与方法
1.1 一般资料 本文选取2013年1月～2018年3月荆门市第一人民医院15 例原发或复发的AF 患者，男 8 例，女 7 例；年龄13～68 岁，平均年龄(37.80±18.35)岁，病程3 d～10 年，平均病程(17.18±12.85)个月。 其中60岁以上2例，16岁以下2例。其中11 例为无痛性肿块，1例有颈部钝痛，2例有腹部不适，1例有下肢肿胀。肿块质硬、活动度差。11例为首发，4 例为复发，复发间隔 6個月～3 年。
1.2仪器与方法 15例患者均行CT 平扫，8例行CT增强；9例行 MRI 平扫，6例MR 增强。CT检查采用GE Lightspeed VCT 64排或Opima CT660 64排机型，层厚 2.5～5 mm，层间距5 mm，STD模式扫描，CT增强扫描经静脉注射优维显或碘海醇60～100 ml(根据体重及年龄差异)， 速率3.0～3.5 ml/s)。MRI检查采用GE Signa HDxt 1.5 T或Discovery MR750 3.0 T磁共振仪，层厚5 mm，层间距 0.5～1.0 mm，行多平面扫描，常规序列采用T1WI、T2WI、压脂T2WI、DWI等序列。MRI 增强扫描注射欧乃影(0.2 ml/kg)，采用压脂T1WI序列。, 百拇医药(车清林)
关键词：侵袭性纤维瘤病；CT及MR表现；组织病理学
中图分类号：R738.6 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.14.050
, http://www.100md.com
文章编号：1006-1959(2018)14-0161-03
Abstract：Objective To analyze the imaging features and histopathological features of aggressive fibromatosis.Methods Retrospective analysis of CT and MRI findings of 15 patients with AF confirmed by postoperative pathology in the First People's Hospital of Jingmen City，Hubei Province from January 2013 to March 2018，and a comparative analysis of MRI and histopathology.Results All the 15 cases underwent CT plain scan，8 cases of CT enhancement，9 cases underwent MRI plain scan，6 cases showed MRI enhancement，CT plain scan showed that 13 cases were uneven and low density，2 cases were more uniform and slightly lower density； 12 cases were unclear，3 cases were clear；8 cases of CT enhancement showed progressive inhomogeneity.MRI scan showed that the tumors of T1WI，T2WI，liposuction，DWI and other tumors were all inhomogeneous signals，with irregular and low signal inclusions，and the edges of the tumors were claw-shaped infiltrated or the edges were unclear.MRI enhancement in 6 cases showed uneven enhancement.Conclusion Both CT and MRI can provide information for the diagnosis of AF from different aspects.MRI can better display the shape，range and edge of the tumor，and can infer the general components of the tumor，which is more helpful for the diagnosis of AF.
, http://www.100md.com
Key words：Aggressive fibromtosis；CT and MRI findings；Histopathological
侵袭性纤维瘤病(aggressive fibromtosis，AF)是一种来源于软组织的纤维组织瘤样增生，呈侵袭性生长，有局部复发倾向，但不发生远处转移[1]。本病发生率为(2～5)/100万，好发于青中年人(25～45 岁为主)，少数发生于儿童及老年人[2]。本病影像精确诊断困难，术前对病灶的性质及与周围结构的关系描述常与术后不符，故本文回顾性分析经术后病理证实的 15 例AF 患者的CT及MRI表现，提高对本病的认识和诊断水平。
1资料与方法
1.1 一般资料 本文选取2013年1月～2018年3月荆门市第一人民医院15 例原发或复发的AF 患者，男 8 例，女 7 例；年龄13～68 岁，平均年龄(37.80±18.35)岁，病程3 d～10 年，平均病程(17.18±12.85)个月。 其中60岁以上2例，16岁以下2例。其中11 例为无痛性肿块，1例有颈部钝痛，2例有腹部不适，1例有下肢肿胀。肿块质硬、活动度差。11例为首发，4 例为复发，复发间隔 6個月～3 年。
1.2仪器与方法 15例患者均行CT 平扫，8例行CT增强；9例行 MRI 平扫，6例MR 增强。CT检查采用GE Lightspeed VCT 64排或Opima CT660 64排机型，层厚 2.5～5 mm，层间距5 mm，STD模式扫描，CT增强扫描经静脉注射优维显或碘海醇60～100 ml(根据体重及年龄差异)， 速率3.0～3.5 ml/s)。MRI检查采用GE Signa HDxt 1.5 T或Discovery MR750 3.0 T磁共振仪，层厚5 mm，层间距 0.5～1.0 mm，行多平面扫描，常规序列采用T1WI、T2WI、压脂T2WI、DWI等序列。MRI 增强扫描注射欧乃影(0.2 ml/kg)，采用压脂T1WI序列。, 百拇医药(车清林)