影像研究与医学应用2024，Vol.8Issue(14) ：22-25,29.

骨脂肪硬化性黏液纤维瘤的影像学特征及误诊分析

Imaging misdiagnosis analysis of liposclerosing myxofibrous tumor

刘艳雯 杨伟萍 黄耀华
影像研究与医学应用2024，Vol.8Issue(14) ：22-25,29.
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  • NETL
  • NSTL
  • 万方数据

骨脂肪硬化性黏液纤维瘤的影像学特征及误诊分析

Imaging misdiagnosis analysis of liposclerosing myxofibrous tumor

刘艳雯 1杨伟萍 1黄耀华1
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作者信息

  • 1. 广州中医药大学第一附属医院<广东省中医临床研究院>影像科 广东 广州 510405
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摘要

目的:探讨骨脂肪硬化性黏液纤维瘤(LSMFT)的影像学表现及误诊情况.方法:选取 2016 年 9 月—2023 年 9 月广州中医药大学第一附属医院收治的经手术病理确诊的7例骨LSMFT患者为研究对象,7例患者行X线及CT平扫检查,5例患者同时行MRI检查,分析LSMFT的影像学表现及误诊情况.结果:7 例患者病灶均为单发,其中 6 例病灶位于股骨粗隆间、1 例病灶位于胫骨近端.X线及CT检查结果显示,7 例患者病变部位均边界清晰、边缘伴厚薄不一硬化边、内见骨嵴或骨分隔及脂肪密度,且 4 例患者病变部位轻度膨胀性,2例患者病变部位伴磨玻璃影,3例患者病变部位邻近骨皮质稍增厚.5例患者MRI检查结果显示,病变部位T1WI等低信号为主、混杂小片或点状高信号,其中脂肪信号被抑脂减低;T2WI混杂等高信号伴局部明亮高信号区;增强扫描均无软组织肿块及瘤周水肿,且3例患者显示轻度不均匀强化,1例患者显示明显不均匀强化、病变内黏液样变区延迟强化.以病理检查结果为金标准,7例行CT检查的患者中 4 例误诊为非骨化性纤维瘤或良性组织纤维瘤、2 例误诊为脂肪瘤、1 例诊断为骨LSMFT,误诊率为 85.71%;5 例行MRI检查的患者中2例误诊为脂肪瘤、3例诊断为骨LSMFT,误诊率为40%.结论:骨LSMFT有特发部位及典型影像学表现,但误诊率较高,综合CT和MRI检查结果可提高其诊断率.

Abstract

Objective To investigate imaging manifestaions of liposclerosing myxofibrous tumor(LSMFT)and to improve the understanding of the lesion and reduce misdiagnosis.Methods 7 cases with operation pathologically confirmed bone liposclerosing myxofibrous tumor between September 2016 and September 2023 were enrolled.Routine CT scan was performed in all patients and MRI scan was performed in 5 patients(4 enhanced and 1 plain scan)preoperatively.Results 7 cases were all solitary,6 cases were located in the femoral intertrochanteric,1 in the proximal tibia.The lesion boundary was clear in all 7 cases,with different thickness of hardening edge and internal bone crest or bone septum and fat.1 case dilated mildly,2 cases had grinding glass density,3cases had cortical thickening of adjacent bone.Among 7 CT scans,4 cases were misdiagnosed as non-ossifying fibroma or benign fibrous histiocytoma,2 cases were misdiagnosed as lipomyoma,1 case was diagnosed as LSMFT.The MRI manifestations on T1WI and T2W1 signals were isointensity with heterogeneous hyperintensity,the lesions were mildly enhanced or mucoid degeneration delayed reinforced.Among 5 MRI scans,2 cases were misdiagnosed as lipomyoma,3 cases were diagnosed as LSMFT.Conclusion LSMFT have susceptible age,predilection site and certain imaging characteristics,combine with CT and MRI scan,diagnosis rate could be improved.

关键词

骨脂肪硬化性黏液纤维瘤/医学影像学/X线/CT/MRI

Key words

Liposclerosing myxofibrous tumor/Medical imaging/X-ray/CT/MRI

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出版年

2024
影像研究与医学应用

影像研究与医学应用

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