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脂肪瘤和脂肪肉瘤中的间隔样结构:磁共振成像与病理对照

Septum-like structures in lipoma and liposarcoma: MR imaging and pathologic correlation.

作者信息

Hosono M, Kobayashi H, Fujimoto R, Kotoura Y, Tsuboyama T, Matsusue Y, Nakamura T, Itoh T, Konishi J

机构信息

Department of Nuclear Medicine, Faculty of Medicine, Kyoto University, Sakyo-ku, Japan.

出版信息

Skeletal Radiol. 1997 Mar;26(3):150-4. doi: 10.1007/s002560050211.

Abstract

OBJECTIVE

To investigate the septum-like structures in predominantly lipomatous tumors, by correlating fat-suppressed MR images with histopathologic findings.

DESIGN AND PATIENTS

The MR findings of three cases of well-differentiated liposarcoma (atypical lipoma), one case of lipoma-like component of dedifferentiated liposarcoma, and nine cases of lipoma were analyzed. T1-, T2-, and fat-suppressed T1-weighted images after Gd-DTPA administration were obtained. Surgical specimens from five patients (four with liposarcoma and one with lipoma) were also scanned with a MR unit, and compared with the pathologic findings.

RESULTS AND CONCLUSIONS

Enhancement features of lipoma and liposarcoma were well visualized on fat-suppressed T1-weighted images after Gd-DTPA administration. The septum-like structures of liposarcoma are thick and enhanced considerably, while septa of lipoma are thin and enhanced only slightly. Pathologically, the septum-like structures of liposarcoma contained muscle fibers and the septa of lipoma represented fibrous capsule. Identification of well-enhanced septa in a predominantly lipomatous tumor helps to differentiate malignant tumors from lipomas. As the septum-like structures of liposarcoma contain a skeletal muscle component the tumor might need more extensive surgical procedures including resection of adjacent muscles.

摘要

目的

通过将脂肪抑制磁共振成像与组织病理学结果相关联,研究以脂肪瘤为主的肿瘤中的间隔样结构。

设计与患者

分析了3例高分化脂肪肉瘤(非典型脂肪瘤)、1例去分化脂肪肉瘤的脂肪瘤样成分及9例脂肪瘤的磁共振成像结果。在静脉注射钆喷酸葡胺(Gd-DTPA)后获取T1加权、T2加权及脂肪抑制T1加权图像。对5例患者(4例脂肪肉瘤患者和1例脂肪瘤患者)的手术标本也进行了磁共振扫描,并与病理结果进行比较。

结果与结论

静脉注射Gd-DTPA后的脂肪抑制T1加权图像上能清晰显示脂肪瘤和脂肪肉瘤的强化特征。脂肪肉瘤的间隔样结构较厚且强化明显,而脂肪瘤的间隔较薄且强化轻微。病理上,脂肪肉瘤的间隔样结构含有肌纤维,脂肪瘤的间隔代表纤维性包膜。在以脂肪瘤为主的肿瘤中识别强化明显的间隔有助于将恶性肿瘤与脂肪瘤区分开来。由于脂肪肉瘤的间隔样结构包含骨骼肌成分,该肿瘤可能需要更广泛的手术操作,包括切除相邻肌肉。

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