原发性肢体脂肪肉瘤：MRI特征、组织病理学及临床结果
Primary Extremity Liposarcoma: MRI Features, Histopathology, and Clinical Outcomes.
作者信息
Wortman Jeremy R, Tirumani Sree Harsha, Jagannathan Jyothi P, Tirumani Harika, Shinagare Atul B, Hornick Jason L, Ramaiya Nikhil H
机构信息
From the *Department of Radiology, Brigham and Women's Hospital, †Department of Imaging, Dana Farber Cancer Institute, and ‡Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
出版信息
J Comput Assist Tomogr. 2016 Sep-Oct;40(5):791-8. doi: 10.1097/RCT.0000000000000431.
OBJECTIVE
This study aimed to describe magnetic resonance imaging (MRI) features of extremity liposarcoma (LPS) subtypes, correlating with histopathology and clinical outcomes.
METHODS
In this retrospective study, we included 125 patients (80 men, 45 women; mean age, 53 years) with extremity LPS [23 atypical lipomatous tumor (ALT), 9 dedifferentiated (DDLPS), 70 myxoid (MLPS), 23 pleomorphic (PLPS)]. Pretreatment MRI of primary tumors in 56 patients (10 ALT, 4 DDLPS, 28 MLPS, 14 PLPS) was reviewed.
RESULTS
All subtypes were predominantly T1 isointense relative to skeletal muscle (DDLPS = 3/4, MLPS = 28/28, PLPS = 13/14) and T2 hyperintense (ALT = 10/10, DDLPS = 3/4, MLPS = 28/28, PLPS = 14/14) except for ALT which were T1 hyperintense (8/10). Within MLPS, high grade was associated with unencapsulated margins (P = 0.05) and solid, nodular enhancement (P < 0.0001). Peritumoral edema (P = 0.03) and T2 heterogeneity (P = 0.05) predicted pulmonary (rather than extrapulmonary) metastases in MLPS. Tumor subtype correlated with mortality (P = 0.04).
CONCLUSIONS
The MRI features can help to distinguish between extremity LPS subtypes, and can predict histopathologic grade and metastatic pattern in myxoid LPS.
目的
本研究旨在描述肢体脂肪肉瘤（LPS）各亚型的磁共振成像（MRI）特征，并将其与组织病理学及临床结果相关联。
方法
在这项回顾性研究中，我们纳入了125例肢体LPS患者（80例男性，45例女性；平均年龄53岁）[23例非典型脂肪瘤性肿瘤（ALT），9例去分化型（DDLPS），70例黏液型（MLPS），23例多形型（PLPS）]。对56例患者（10例ALT，4例DDLPS，28例MLPS，14例PLPS）原发性肿瘤的治疗前MRI进行了回顾。
结果
除ALT为T1高信号（8/10）外，所有亚型相对于骨骼肌主要为T1等信号（DDLPS = 3/4，MLPS = 28/28，PLPS = 13/14）和T2高信号（ALT = 10/10，DDLPS = 3/4，MLPS = 28/28，PLPS = 14/14）。在MLPS中，高级别与无包膜边缘（P = 0.05）以及实性、结节状强化（P < 0.0001）相关。瘤周水肿（P = 0.03）和T2信号不均匀性（P = 0.05）可预测MLPS发生肺（而非肺外）转移。肿瘤亚型与死亡率相关（P = 0.04）。
结论
MRI特征有助于区分肢体LPS亚型，并可预测黏液型LPS的组织病理学分级和转移模式。
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