| 软组织恶性纤维组织细胞瘤的超声及MRI影像表现 |
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投稿时间：2019-02-23
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| 作者 | Author | 单位 | Address | E-Mail |
| 梁海燕 |
LIANG Hai-yan |
湖州市中心医院超声科, 浙江 湖州 313000 |
Department of Ultrasound, Huzhou Central Hospital, Huzhou 313000, Zhejiang, China |
lianghy2002@126.com |
| 胡新娥 |
HU Xin-e |
湖州市中心医院超声科, 浙江 湖州 313000 |
Department of Ultrasound, Huzhou Central Hospital, Huzhou 313000, Zhejiang, China |
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| 徐万里 |
XU Wan-li |
湖州市中心医院放射科, 浙江 湖州 313000 |
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| 韩运生 |
HAN Yun-sheng |
湖州市中心医院超声科, 浙江 湖州 313000 |
Department of Ultrasound, Huzhou Central Hospital, Huzhou 313000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2019年，第32卷，第8期，第736-741页 |
| DOI：10.3969/j.issn.1003-0034.2019.08.012 |
| 基金项目: |
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中文摘要:
目的：探讨软组织内恶性纤维组织细胞瘤（malignant-fibrous histiocytoma，MFH）的超声及MRI影像表现。
方法：分析2012年1月至2018年8月期间经手术及病理证实的12例软组织内恶性纤维组织细胞瘤患者的超声、MRI影像资料及病理资料，其中男7例，女5例；年龄36~69岁，平均53岁；病程4~49个月，平均28个月。临床表现为软组织肿块和患肢疼痛。术前行超声、MRI平扫及增强检查。对病灶部位、形态、回声/信号特点、彩色血流信号及强化特征进行观察，并与病理结果进行对照。
结果：12例MFH中9例为原发病灶，3例为术后复发病灶。双侧大腿7例，小腿2例，上臂1例，臀部1例，后腹膜1例。病灶大小5.1~17.1 cm，平均8.7 cm。超声表现为分叶状或团块状，以低回声为主，5例有包膜，边界清；7例与周围组织分界不清；6例内部见不规则无回声区。CDFI周边均可见较丰富血流信号，内部血流信号多少不等。MRI表现为分叶状、团块状或不规则形，T1WI呈略低信号或等信号，T2WI呈高信号，DWI信号增高；6例内部见混杂信号，7例内部见低信号分隔，5例见假包膜，9例呈浸润生长伴周围水肿。T1WI增强后均呈明显不均匀强化。免疫组化表达Vim、CD68阳性。
结论：软组织MFH的发病年龄、部位及影像学表现具有一定特征性。发生在中老年人四肢软组织内的不规则肿块，回声和信号表现均匀或混杂，肿块内见分隔、坏死及囊变区，血流信号丰富、实性成分强化明显时，应考虑到MFH的诊断。 |
| 【关键词】组织细胞瘤,恶性纤维 软组织肿瘤 超声检查 磁共振成像 |
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| Ultrasound and MRI features of malignant fibrous histiocytoma of soft tissue |
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ABSTRACT
Objective:To investigate ultrasound and MRI features of malignant fibrous histiocytoma (MFH) of soft tissue.
Methods:Ultrasound,MRI images and pathological data of 12 patients with malignant fibrous histiocytoma in soft tissue confirmed by operation and pathology were analyzed from January 2012 to August 2018,inlcuding 7 males and 5 females,aged from 36 to 69 years old with an average age of 53 years old;the courses of disease ranged from 4 to 49 months with an average of 28 months. Clinical manifestations were soft tissue masses and pain in the affected limbs. Ultrasound,MRI and contrast-enhanced examination were performed before operation. The lesions,morphology,echo/signal characteristics,color flow signals and enhancement features were observed and compared with pathology.
Results:In 12 patients with MFH,9 patients were primary lesions and 3 patients were recurrent lesions after operation. There were 7 cases of bilateral thighs,2 cases of calves,1 case of upper arm,1 case of buttocks and 1 case of posterior peritoneum. The size ranged from 5.1 to 17.1 cm with an average of 8.7 cm. Ultrasound feature showed lobulated or agglomerate,and focused on low echo;5 cases had capsule and with clear border;7 cases were unclear boundary with surrounding tissues;and 6 cases with irregular echo-free. The blood flow signals were around the CDFI,and the internal blood flow signals were different. MRI feature showed lobulated,agglomerate or irregular shape,T1WI showed slightly lower signal or equal signal,T2WI showed high signal and DWI signal increased. Six patients manifested mixed signal inside,7 patients manifested low signal separation inside,5 patients with false envelope,and 9 patients manifested infiltration and growth with peripheral edema. T1WI showed uneven strengthening after enhancement. Immunohistochemical expression of Vim,CD68 were positive.
Conclusion:The age,location and imaging features of soft tissue MFH are characteristic. The diagnosis of MFH should be considered when irregular mass occurred in soft tissues of limbs at middle-aged and old people. Echo and signal are homogeneous or mixed. Separation,necrosis and cystic degeneration could be seen in the mass. When the blood flow signals are abundant and solid components are obviously enhanced,the diagnosis of MFH should be considered. |
| KEY WORDS Histiocytoma,malignant fibrous Soft tissue neoplasms Ultrasonography Magnetic resonance imaging |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 梁海燕,胡新娥,徐万里,韩运生.软组织恶性纤维组织细胞瘤的超声及MRI影像表现[J].中国骨伤,2019,32(8):736~741 |
| 英文格式: | LIANG Hai-yan,HU Xin-e,XU Wan-li,HAN Yun-sheng.Ultrasound and MRI features of malignant fibrous histiocytoma of soft tissue[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(8):736~741 |
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