结节性筋膜炎的MRI表现与病理分型对照

目的 探讨结节性筋膜炎(NF)的组织病理学分型及其相应的MRI特征。方法 回顾性分析19例经手术病理证实的软组织NF患者的MRI资料,分析其MRI表现特点,并与组织病理学分型进行对照分析。结果 19例患者中,黏液型8例,细胞型4例,纤维型7例。黏液型NF含有较多黏液基质,其中6例病灶中央区细胞排列疏松并见液化区;8例患者T1WI均呈稍高信号,6例T2WI呈"反靶征"表现。细胞型NF细胞成分较多,毛细血管分布均匀,4例病灶的MRI信号及内部强化均相对较均匀。7例纤维型NF病灶中5例中央富含胶原成分,T2WI于相应区域可见"中央纤维瘢痕征"。结论 各型NF的MRI表现具有一定特征性,可反映其组织病理学改变。

Comparative analysis of MRI features and histopathological classification of nodular fasciitis

Objective To explore the histopathological type and MR imaging features of nodular fasciitis (NF). Methods Nineteen patients with NF proved pathologically were studied retrospectively. MR imaging features and histopathological appearances of NF were analyzed. Results All 19 patients were classified into three subtypes:Myxoid, cellular and fibrous subtype were 8, 4, 7 patients respectively. The myxoid lesions contained more extracellular myxoid matrix; the center cells were loosely packed and interspersed with area of liquid in 6 patients; all the myxoid lesions showed a slight high signal intensity on T1WI, and 6 lesions showed an "inverted target" sign on T2WI. In the cellular lesions, the cells were arranged closely, and capillaries were distributed evenly; the lesions demonstrated homogenous signal intensity on MRI and homogeneously marked enhancement after contrast administration. The center of 5 fibrous lesions were abundant in collagen, and the sign of "central fibrotic scar" were observed in the corresponding area on T2WI. Conclusion Each subtype of NF has certain MR imaging features respectively, which can reflect its histopathological appearances.