【摘要】 目的:探讨恶性纤维组织细胞瘤(MFH)的CT及MRI征象,提高对该病的诊断水平。方法:搜集15例经手术病理确诊的MFH影像学资料进行回顾性分析,其中12例行CT检查,4例行MRI检查,2例行CT与MRI检查。结果:6例瘤体位于四肢,类圆形,边界模糊;其中2例MRI表现为T1WI呈等或稍低信号,T2WI稍高混杂信号;其中2例在术后随访过程中原位复发。1例瘤体位于腰背部,边界模糊,邻近骨质可见破坏征象;T1WI呈等信号,T2WI呈高、稍高混杂信号。3例瘤体位于腹膜后,其中1例最大径约12cm,分叶状,CT增强实质部分中度强化。少见部位:左颞叶、上颌窦、肺部、肝脏、肾脏各1例,其中肝脏MFH术后复发并多处转移。结论:恶性纤维组织细胞瘤CT、MRI表现多样,位于四肢和腹膜后MFH影像表现具有一定鉴别特点,少见部位MFH影像鉴别复杂,最终靠病理确诊。更多还原

【Abstract】 Objective:To discuss the CT and MRI findings of malignant fibrous histiocytoma,and to improve its radiological diagnosis.Methods:A retrospective analysis was made of the imaging data of 15 pathologically confirmed cases of malignant fibrous histiocytoma,CT examination was done in 12 cases,MRI examination in 4 cases,both CT and MRI examination in 2 cases.Results:Six cases had lesions located in the limb muscles,the tumors were round in shape and unclear at the edges,in which 2 cases presented hypointensity and isointensity on T1WI,hyper-or mixed intensity on T2WI,and 2 cases had tumor recurrence at the original site.One case had lesion in the back,unclear at the edges,T1WI showed hypointensity and isointensity and T2WI showed hyper-or mixed intensity.Three cases had lesions located in the retroperitoneal space,the maximum diamaeter of the tumor was 12cm,the shape was multilobulated,enhanced scan showed a moderate peripheral enhancement.Five cases had lesions located in uncommon places:temporal lobe in 1 case,maxillary sinus in 1 case,lung in 1 case,kidney in 1 case and liver in 1 case.The tumor in liver had multiple retroperitoneal space metastases on follow-ups.Conclusion:The imaging findings of MFH located in the limb muscles and retroperitoneal space have certain characteristic manifestations.It is difficult for CT/MRI performance to differentiate those lesions located at uncommon sites,and the diagnosis needs the help of pathologic examinations.更多还原