Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
Skeletal Radiol. 2012 Sep;41(10):1263-72. doi: 10.1007/s00256-012-1417-2. Epub 2012 May 12.
To determine common imaging features of low-grade fibromyxoid sarcoma (LGFMS), a rare subtype of fibrosarcoma with a benign histological appearance but with a propensity for local recurrence and metastasis.
By review of medical records, 29 patients (14 males, 15 females) with mean age of 41 years (range, 11-64 years) with diagnosis of LGFMS and imaging available in PACS were identified. The study included radiography (9/29), ultrasound (1/29), CT (14/29), and MRI (22/29). Imaging features evaluated included anatomic site, and lesion size, number, location, US echogenicity, CT attenuation, calcifications, MR signal intensity pattern, and contrast enhancement.
Twenty-two patients had imaging at initial diagnosis, and seven had imaging only at local recurrence. The majority of tumors (27/29) were deep in tissue, with mean size of 6.2 cm (range, 1.4-19.0 cm). Tumor was single at initial diagnosis and multiple at local recurrence; lower extremity was the most common site. On radiographs, tumor was visible in four of nine without bone erosion or calcification. Areas of CT attenuation hypodense to muscle were seen in 13/14 patients. Calcification was uncommon (3/14). On fluid-sensitive MRI sequences, the predominant signal intensity was hyperintense to muscle in 11/21 patients. In 13/21 patients, tumor displayed either a brain gyriform pattern of alternating hypointense and hyperintense signal intensity (9/13) or intralesional nodules (3/13); 1 case had both patterns. On US tumor was solid with heterogeneous echogenicity.
LGFMS is commonly single at initial diagnosis and multiple at local recurrence. LGFMS frequently shows areas of CT attenuation hypodense to muscle and gyriform patterns of signal intensity and contrast enhancement at MRI.
确定低度纤维黏液样肉瘤（LGFMS）的常见影像学特征，LGFMS 是一种罕见的纤维肉瘤亚型，组织学表现良性，但具有局部复发和转移的倾向。
通过病历回顾，共确定了 29 例（男 14 例，女 15 例）平均年龄 41 岁（范围 11-64 岁）的 LGFMS 患者，且 PACS 中可获得影像学资料。研究包括 X 线摄影（9/29）、超声（1/29）、CT（14/29）和 MRI（22/29）。评估的影像学特征包括解剖部位、病变大小、数量、位置、US 回声强度、CT 衰减、钙化、MR 信号强度模式和对比增强。
22 例患者在初次诊断时有影像学表现，7 例仅在局部复发时有影像学表现。大多数肿瘤（27/29）位于深部组织，平均大小为 6.2cm（范围 1.4-19.0cm）。初次诊断时肿瘤为单发，局部复发时为多发；下肢是最常见的部位。X 线摄影上，4 例可见无骨侵蚀或钙化的肿瘤。14 例 CT 衰减区呈肌肉密度低信号。钙化少见（3/14）。在液体敏感 MRI 序列上，11/21 例患者的主要信号强度为肌肉高信号。在 13/21 例患者中，肿瘤表现为脑回样的低信号和高信号交替（9/13）或瘤内结节（3/13）；1 例同时存在两种模式。在 US 上，肿瘤为实性，回声强度不均匀。
LGFMS 初次诊断时通常为单发，局部复发时为多发。LGFMS 在 CT 上常表现为肌肉密度低信号区，MRI 上表现为脑回样信号强度和对比增强模式。
