Link T M, Haeussler M D, Poppek S, Woertler K, Blasius S, Lindner N, Rummeny E J
Institute of Clinical Radiology, University Hospital, Münster, Germany.
Skeletal Radiol. 1998 Oct;27(10):552-8. doi: 10.1007/s002560050436.
To evaluate the conventional X-ray and MR imaging features of malignant fibrous histiocytoma (MFH) of bone.
MRI examinations and conventional radiographs were reviewed in 39 patients with biopsy-proven MFH. Imaging characteristics were analyzed and the differential diagnoses assessed in a masked fashion by two experienced radiologists.
Typical X-ray features included aggressive, destructive tumor growth centrally located in the metaphysis of long bones. Periosteal reactions and expansive growth were rarely seen. On MR images extraosseous tumor spread was frequently noted. On T2-weighted images and contrast-enhanced T1-weighted images most of the tumors displayed an inhomogeneous, nodular signal pattern with peripheral Gd-DTPA enhancement.
Although several MR imaging criteria were typical for MFH none of them was specific. X-ray diagnosis of MFH may also prove difficult, with the main differential diagnosis being metastasis in the older and osteosarcoma in the younger population.
评估骨恶性纤维组织细胞瘤（MFH）的传统X线和磁共振成像（MR）特征。
对39例经活检证实为MFH的患者的MRI检查和传统X线片进行回顾。分析影像学特征，并由两位经验丰富的放射科医生以盲法评估鉴别诊断。
典型的X线特征包括位于长骨干骺端中央的侵袭性、破坏性肿瘤生长。很少见到骨膜反应和膨胀性生长。在MR图像上，常可见肿瘤向骨外扩散。在T2加权像和对比增强T1加权像上，大多数肿瘤表现为不均匀的结节状信号模式，周围有钆喷替酸葡甲胺（Gd-DTPA）强化。
虽然有几个MR成像标准是MFH的典型表现，但均无特异性。MFH的X线诊断也可能困难，主要鉴别诊断在老年患者为转移瘤，在年轻患者为骨肉瘤。
