本研究的目的是分析骨纤维增生性纤维瘤(DFB)的临床和影像学特征,以正确诊断。
纳入20例经病理证实的DFB患者,并对影像学表现进行了分析。在20名患者中,所有患者均行X线平片,12例进行了计算机断层扫描(CT),8例进行了磁共振成像(MRI)。对临床和影像学表现进行分析和分类,以帮助正确诊断。
找到20名DFB患者,包括11名男性和9名女性,年龄范围为2-52岁(中位数27)。DFB涉及六名患者的股骨,在五个髂骨,胫骨四号,肱骨一分为二,腰椎合二为一,半径为1,剩下的跟骨.DFB常见于长骨的干phy端,可累及骨干和骨phy。影像学表现分为四种类型:十例患者的囊性扩张性破坏,五,溶骨破坏,四个混合破坏,并在一个旁骨破坏。病变区CT值为30-60Hu(6例CT值为45Hu)。在8名接受MRI扫描的患者中,5例患者在T1WI上出现不均匀相等或低信号,在T2WI上出现不均匀相等或高信号,在T1WI和T2WI上有不规则的条纹或低信号斑块。剩下的三个病人,病变在T1WI上均匀相等或低信号,在T2WI上均匀高信号。MRI更清楚地显示邻近软组织中的肿块和DFB病变中的水肿范围。
DFB是一种罕见的肿瘤,具有很强的局部侵袭性,囊性骨破坏,肿瘤骨小梁的形成,影像学上的软组织肿块,病变中T1WI和T2WI上的低信号,但没有骨膜反应或钙化,这有助于疾病的诊断和与其他疾病的鉴别。
The objective of this study is to analyze the clinical and imaging features of desmoplastic fibroma of bone (DFB) for correct diagnosis.
Twenty patients with DFB confirmed by pathology were enrolled, and the imaging presentations were analyzed. Among 20 patients, plain X-ray was performed in all patients, computed tomography (CT) was performed in 12, and magnetic resonance imaging (MRI) was conducted on eight. The clinical and imaging presentations were analyzed and classified to assist in correct diagnosis.
Twenty patients with DFB were retrieved, including eleven males and nine females with an age range of 2-52 years (median 27). The DFB involved the femur in six patients, ilium in five, tibia in four, humerus in two, lumbar vertebra in one, radius in one, and calcaneus in the remaining one. DFB was common in the metaphysis of long bones and could involve the diaphysis and epiphysis. The imaging presentations were divided into four types: the cystic expansile destruction in ten patients, osteolytic destruction in five, mixed destruction in four, and paraosseous destruction in one. CT value was 30 -60 Hu in the lesion area (6 cases CT value45Hu). In eight patients with MRI scanning, the lesion in five patients presented with unevenly equal or low signal on T1WI and unevenly equal or high signal on T2WI, with irregular stripes or patches of low signal on both T1WI and T2WI. In the rest three patients, the lesion was evenly equal or low signal on T1WI and evenly high signal on T2WI. MRI more clearly showed a mass in the adjacent soft tissue and the range of edema in the DFB lesion.
DFB is a rare tumor with strong local aggressiveness, cystic bone destruction, formation of tumor bone trabeculae, soft tissue masses on imaging presentations, low signals on T1WI and T2WI in the lesion, but no periosteal reaction or calcification, which are helpful for diagnosis of the disease and differentiation from other ones.