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目的:探讨四肢、躯干软组织原发性脂肪肉瘤CT和MRI特点,以提高其诊断水平。方法:对经手术及病理证实的12例四肢、躯干软组织原发性脂肪肉瘤的CT和MRI表现及特征与术后病理标本进行回顾性对照分析。其中行CT检查7例,MRI检查11例,二者均检查6例。结果:12例中,分化成熟型6例,黏液型3例,多形性2例,去分化型1例。肿瘤形态不规则7例,规则5例,直径6.1～19.9cm。分化成熟型含有大量成熟脂肪,CT和MRI显示脂肪组织,密度/信号较均匀,边界清晰;黏液样脂肪肉瘤含有丰富黏液基质,部分含有分化较好的脂肪团,CT和MRI显示脂肪团,密度/信号较不均匀;多形性脂肪肉瘤密度/信号不均匀,邻近组织易累及和瘤周水肿;去分化型瘤体体积大,密度/信号明显不均匀,增强明显强化。结论:CT和MRI表现及特征能反映四肢、躯干软组织脂肪肉瘤的组织学特点,可清楚地显示肿瘤的大小、边界、累及范围及其与周围组织的关系,可初步评估肿瘤的分化及恶性程度。
Objective: To investigate the CT and MRI features of primary liposarcomas of the limbs and trunk soft tissues in order to improve their diagnosis. Methods: CT and MRI findings and characteristics of postoperative pathological specimens of 12 cases of primary liposarcomas of the limbs and trunk soft tissue confirmed by surgery and pathology were retrospectively analyzed. CT scans were performed in 7 cases and MRI in 11 cases. Both were examined in 6 cases. RESULTS: Of the 12 cases, 6 cases were of mature differentiation type, 3 cases of mucinous type, 2 cases of polymorphism, and 1 case of dedifferentiated type. Irregular tumors in 7 cases, rules in 5 cases, diameter 6.1 to 19.9cm. Differentiated mature type contains a lot of mature fat, CT and MRI showed adipose tissue, a more uniform density/signal, a clear boundary; myxoid liposarcoma is rich in mucus matrix, some of which contain well-differentiated cellulite, CT and MRI show cellulite, density / Signal is not uniform; pleomorphic liposarcoma density / signal is not uniform, adjacent tissue involving and peritumoral edema; dedifferentiation type tumor volume, density / signal significantly uneven, enhanced significantly enhanced. Conclusion: The CT and MRI features and characteristics can reflect the histological features of limbs and soft tissues of the trunk soft tissue sarcoma. The size, boundary and range of involvement of the tumor and its relationship with the surrounding tissue can be clearly displayed. The degree of differentiation and malignancy of the tumor can be initially assessed. .