CAJ | 학술논문

目的：探讨韧带样纤维瘤病（DF）的MRI特点，重点分析MRI特征影像及其病理基础，评价MRI在DF诊断中的价值。方法回顾性分析经手术病理证实14例韧带样纤维瘤病的M RI表现（14个病灶均行M RI增强及延迟扫描），与术后病理结果进行比较，并探讨M RI特征影像的病理基础。结果14例均为单发病灶（腹外型7例、腹壁型4例、腹内型3例），其中有2例为术后复发，肿瘤沿着肌肉长轴生长。T1 WI呈等或稍低于肌肉的信号，T2 WI呈高于肌肉信号，增强扫描病灶均呈不均匀强化，以延迟强化为明显，病灶内可见条状或带状 T1 WI及 T2 WI低信号，增强后未见强化。14例病灶内均未见坏死、囊变及瘤周水肿。病理组织学上肿瘤由不同比例的成纤维细胞、纤维组织和胶原纤维束组成，纤维细胞及成纤维细胞密集区域T2 WI信号增高，而肿瘤内胶原纤维区域在 T1 WI、T2 WI均为低信号。肿瘤内见较多血管壁完整的毛细血管，这是病灶延迟强化的病理基础。结论病灶内可见T1 WI、T2 WI均呈带状低信号且增强扫描不强化以及病灶延迟强化是DF的特征性M RI表现。M RI可以很好评估肿瘤侵犯范围及其与周围结构的关系，有助于DF的诊断和鉴别诊断。
목적：탐토인대양섬유류병（DF）적MRI특점，중점분석MRI특정영상급기병리기출，평개MRI재DF진단중적개치。방법회고성분석경수술병리증실14례인대양섬유류병적M RI표현（14개병조균행M RI증강급연지소묘），여술후병리결과진행비교，병탐토M RI특정영상적병리기출。결과14례균위단발병조（복외형7례、복벽형4례、복내형3례），기중유2례위술후복발，종류연착기육장축생장。T1 WI정등혹초저우기육적신호，T2 WI정고우기육신호，증강소묘병조균정불균균강화，이연지강화위명현，병조내가견조상혹대상 T1 WI급 T2 WI저신호，증강후미견강화。14례병조내균미견배사、낭변급류주수종。병리조직학상종류유불동비례적성섬유세포、섬유조직화효원섬유속조성，섬유세포급성섬유세포밀집구역T2 WI신호증고，이종류내효원섬유구역재 T1 WI、T2 WI균위저신호。종류내견교다혈관벽완정적모세혈관，저시병조연지강화적병리기출。결론병조내가견T1 WI、T2 WI균정대상저신호차증강소묘불강화이급병조연지강화시DF적특정성M RI표현。M RI가이흔호평고종류침범범위급기여주위결구적관계，유조우DF적진단화감별진단。
Objective To explore the magnetic resonance imaging (MRI) features of desmoid-type fibromatosis (DF) ,to analyze emphatically the correction of M RI characteristic features and pathological basis of DF ,and to evaluate the value of MRI in the diagnosis of DF .Methods The MRI imaging characteristics of 14 patients with DF confirmed pathologically were retrospectively analyzed (all the patients were scaned with contrast enhance ) and compared with findings of patholo-gy .Results 14 cases were single lesion (7 lesions were extre-abdominal ,4 lesions were located in the abdominal wall ,oth-ers were intra-abdominal) ,two of which were postoperative recurrence .The tumors developed along the long axis of mus-cle .The tumors were show isointense or hypointense on T1-weighted and hyperintense on T2-weighted relative to muscle , all lesions were heterogeneous enhancement ,especially on delay-enhancement .There were speckle-shaped and strip-shaped areas of low signal intensity on both T1WI and T2WI within the tumors ,which were not-enhanced .There were no necro-sis ,cystic and surrounding edema in the lesions of all the cases .It was revealed by pathology study that the tumor was composed of different proportions of lively proliferative fibroblasts ,fibrocytes and collagenous fiber bundles .Compact fi-broblasts and fibrocytes areas showed higher SI on T2WI .There was abundant blood capillary in the tumor ,which was the lesson for pathological foundation of delay-enhancement .Conclusion There were no-enhanced speckle-shaped and strip-shaped areas of low signal intensity on both T1WI and T2WI within the tumors ,and the tumor was delay-enhanced ,which were the MRI features of DF .MRI can well evaluate the scope of tumor invasion and its relationship with surrounding structures ,as well as be helpful for diagnosis and differential diagnosis of DF .