Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Department of Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054.
AJR Am J Roentgenol. 2020 Jul;215(1):178-183. doi: 10.2214/AJR.19.22163. Epub 2020 May 14.
We undertook this study to determine the radiologic features of desmo-plastic fibroblastoma. We reviewed available radiologic images for 29 pathologically confirmed desmoplastic fibroblastomas, including images from MRI, radiography, ultrasound (US), and CT. The patient population included 14 women and 15 men (mean age, 60 years; range, 23-96 years). Typically, lesions were oval or lobulated and relatively small (mean, 5.6 cm). In 14 of the 22 cases that included patient histories, lesions had grown slowly, with two eventually causing pain. The remaining eight were discovered incidentally. All lesions involved or were below the deep fascia. Lesions were well-defined and associated with muscle (45%), deep fascia (28%), joint (21%), or tendon (7%). MR images were available in 26 cases; 14 included unenhanced and contrast-enhanced studies. On MRI imaging all lesions were well-defined and adjacent to dense connective tissue. On T1-weighted images, lesions showed varying amounts of low and intermediate signal intensity similar to that of tendon and skeletal muscle, respectively. On fluid-sensitive images, lesions were more heterogeneous, generally showing a wider spectrum of decreased to intermediate signal intensity. On contrast-enhanced MR images, enhancement was characteristically peripheral and septal with patchy areas of homogeneity. In the 10 cases with radiographs, images showed negative findings or a nonmineralized mass. The 10 available ultrasound studies showed mixed echogenicity. In eight patients, unenhanced CT showed lesions having attenuation similar to that of skeletal muscle. Desmoplastic fibroblastoma is an uncommon neoplasm with a relatively characteristic MRI appearance.
我们进行这项研究是为了确定促纤维组织增生性纤维瘤的放射学特征。我们回顾了 29 例经病理证实的促纤维组织增生性纤维瘤的现有影像学图像，包括 MRI、X 线摄影、超声（US）和 CT 图像。患者人群包括 14 名女性和 15 名男性（平均年龄 60 岁；范围 23-96 岁）。典型的病变呈椭圆形或分叶状，相对较小（平均直径 5.6cm）。在包括病史的 22 例中的 14 例中，病变生长缓慢，其中 2 例最终引起疼痛。其余 8 例为偶然发现。所有病变均累及或位于深筋膜以下。病变边界清楚，与肌肉（45%）、深筋膜（28%）、关节（21%）或肌腱（7%）相关。26 例中有 MRI 图像，其中 14 例包括未增强和增强研究。MRI 图像上所有病变均边界清楚，与致密结缔组织相邻。在 T1 加权图像上，病变表现出不同程度的低信号和中等信号强度，分别类似于肌腱和骨骼肌。在液体敏感图像上，病变更不均匀，通常显示更广泛的低到中等信号强度。在对比增强 MRI 图像上，增强表现为特征性的外周和间隔性，伴有片状均匀性。在 10 例 X 线摄影中，图像显示阴性发现或无矿化肿块。10 例可获得的超声研究显示混合回声。在 8 例患者中，未增强 CT 显示病变的衰减与骨骼肌相似。促纤维组织增生性纤维瘤是一种罕见的肿瘤，具有相对特征性的 MRI 表现。
