腹部纤维母细胞/肌纤维母细胞性肿瘤的PET/CT影像学特点及其应用价值
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摘要
目的分析腹部纤维母细胞/肌纤维母细胞性肿瘤的PET/CT影像学表现,提高对该少见病的认识。方法搜集经手术或穿刺病理证实的腹部肌纤维源性肿瘤28例,分析其PET/CT表现。统计学方法采用独立样本t检验、方差齐性检验。结果 (1)中间型组有侵袭性纤维瘤病13例、孤立性纤维性肿瘤10例、肌纤维母细胞肿瘤3例;恶性组有纤维肉瘤2例。16例位于腹腔内、12例位于腹膜后,平均直径为12.4 cm。(2)PET/CT发现病灶以局部脂肪浸润或脏器浸润为主,所有病例均无淋巴结转移,3例出现远处转移。(3)侵袭性纤维瘤病、孤立性纤维性肿瘤、肌纤维母细胞肿瘤、纤维肉瘤的SUVmax均值分别为4.9、3.6、5.6和17.9,前三组(中间型)之间差异无统计学意义,但明显低于纤维肉瘤(恶性)。结论 PET/CT有助于提示腹部纤维母细胞/肌纤维母细胞性肿瘤的术前TNM分期;SUVmax值有助于肿瘤恶性程度的判断。
Objective To analyze the PET/CT imaging features of abdominal fibroblastic/myofibroblastic tumors and to improve the understanding of this rare disease. Methods We collected 28 cases of abdominal myofibroblastic tumors confirmed by operation or puncture pathology. The PET/CT manifestations of the tumors were analyzed. Statistical methods were independent sample t test and homogeneity of variance test.Results(1) There were 13 cases of aggressive fibromatosis, 10 cases of solitary fibrous tumors and 3 cases of myofibroblastoma in intermediate group and 2 cases of fibrosarcoma in malignant group. 16 cases were located in the abdominal cavity and 12 cases were located in the retroperitoneum with an average diameter of 12.4 cm.(2) PET/CT showed that the main lesions were local fat infiltration or organ invasion. No lymph node metastasis was found in any case, and distant metastasis occurred in 3 cases.(3) The mean SUVmax values of aggressive fibromatosis, solitary fibrous tumors, myofibroblastoma and fibrosarcoma were 4.9, 3.6,5.6 and 17.9. There was no statistical difference among the first three groups(intermediate type), but they were significantly lower than that of fibrosarcoma(malignant type). Conclusion PET/CT is helpful for preoperative TNM staging of abdominal fibroblastic/myofibroblastic tumors. SUVmax value is helpful to indicate the malignant degree of tumors.
Objective To analyze the PET/CT imaging features of abdominal fibroblastic/myofibroblastic tumors and to improve the understanding of this rare disease. Methods We collected 28 cases of abdominal myofibroblastic tumors confirmed by operation or puncture pathology. The PET/CT manifestations of the tumors were analyzed. Statistical methods were independent sample t test and homogeneity of variance test.Results(1) There were 13 cases of aggressive fibromatosis, 10 cases of solitary fibrous tumors and 3 cases of myofibroblastoma in intermediate group and 2 cases of fibrosarcoma in malignant group. 16 cases were located in the abdominal cavity and 12 cases were located in the retroperitoneum with an average diameter of 12.4 cm.(2) PET/CT showed that the main lesions were local fat infiltration or organ invasion. No lymph node metastasis was found in any case, and distant metastasis occurred in 3 cases.(3) The mean SUVmax values of aggressive fibromatosis, solitary fibrous tumors, myofibroblastoma and fibrosarcoma were 4.9, 3.6,5.6 and 17.9. There was no statistical difference among the first three groups(intermediate type), but they were significantly lower than that of fibrosarcoma(malignant type). Conclusion PET/CT is helpful for preoperative TNM staging of abdominal fibroblastic/myofibroblastic tumors. SUVmax value is helpful to indicate the malignant degree of tumors.
引文
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[14]Ballo MT,Zagars GK,Pollock RE,et al.Retroperitoneal soft tissue sarcoma:an analysis of radiation and surgical treatment[J].Int J Radiat Oncol Biol Phys,2007,67(1):158-63.
[2]Lee JC,Thomas JM,Phillips S,et al.Aggressive fibromatosis:MRIfeatures with pathologic correlation[J].AJR Am J Roentgenol,2006,186(1):247-54.
[3]邓新源,梁菊香,罗志程.韧带样型纤维瘤病MR征象及病理[J].影像诊断与介入放射学,2010,19(4):216-8.[Deng XY,Liang JX,Luo ZC.Clinical,MR imaging and pathological features of desmoid-type fibromatosis[J].Ying Xiang Zhen Duan Yu Jie Ru Fang She Xue,2010,19(4):216-8.]
[4]彭俊萍,张雪林,吕晓飞,等.韧带样纤维瘤的影像表现与病理对照[J].临床放射学杂志,2011,30(8):1166-9.[Peng JP,Zhang XL,Lyu XF,et al.Imaging Findings of Desmoid Type Fibromatoses:Comparison with Pathological Results[J].Lin Chuang Fang She Xue Za Zhi,2011,30(8):1166-9.]
[5]杨吉龙,王坚,朱雄增.韧带样型纤维瘤病的病理学和遗传学研究进展[J].中华病理学杂志,2005,34(8):537-9.[Yang JL,Wang J,Zhu XZ.Progress in the research of pathology and genetics of desmoid tumor[J].Zhonghua Bing Li Xue Za Zhi,2005,34(8):537-9.]
[6]Ginat DT,Bokhari A,Bhatt S,et al.Imaging features of solitary fibrous tumors[J].AJR Am J Roentgenol,2011,196(3):487-95.
[7]刘毅,刘剑羽,王宏磊,等.孤立性纤维瘤的影像表现[J].中华放射学杂志,2012,46(5):441-4.[Liu Y,Liu JY,Wang HL,et al.Imaging findings of solitary fibrous tumors[J].Zhonghua Fang She Xue Za Zhi,2012,46(5):441-4.]
[8]Nagasako Y,Misawa K,Kohashi S,et al.Solitary fibrous tumor in the retroperitoneum[J].J Am Coll Surg,2004,198(2):322-3.
[9]吕绍茂,段少银,韩丹,等.炎性肌纤维母细胞瘤影像学表现与病理学分析[J].中国临床医学影像杂志,2010,21(5):331-4.[Lv SM,Duan SY,Han D,et al.The imaging and pathology of inflammatory myofibroblastic tumor[J].Zhongguo Lin Chuang Yi Xue Ying Xiang Za Zhi,2010,21(5):331-4.]
[10]赵登玲,邓钢,张丽华,等.孤立性纤维瘤的影像学特征及良恶性对比分析[J].肿瘤,2013,33(5):454-9.[Zhao DL,Deng G,Zhang LH,et al.Solitary fibrous tumors:Imaging features and differentiation between benign and malignant tumors[J].Zhong Liu,2013,33(5):454-9.]
[11]苏金亮,周利民,纪建松,等.侵袭性纤维瘤病的CT及MRI特征[J].放射学实践,2011,26(5):497-500.[Su JL,Zhou LM,Ji JS,et al.CT and MRI feaatures of abdominal aggresive fibromatosis[J].Fang She Xue Shi Jian,2011,26(5):497-500.]
[12]丁重阳,李天女,吉爱兵.原发性腹膜后恶性肿瘤的18F-FDGPET/CT显像特征[J].中国临床医学影像杂志,2014,25(9):674-6.[Ding CY,Li TN,Ji AB.Manifestations of 18F-FDGPET/CT scanning in primary retroperitoneal malignant tumors[J].Zhongguo Lin Chuang Yi Xue Ying Xiang Za Zhi,2014,25(9):674-6.]
[13]Azadi J,Subhawong A,Durand DJ.F-18-FDG PET/CT and Tc-99m sulfur colloid SPECT imaging in the diagnosis and treatment of a case of dual solitary fibrous tumors of the retro peritoneum and pancreas[J].J Radiol Case Rep,2012,6(3):32-7.
[14]Ballo MT,Zagars GK,Pollock RE,et al.Retroperitoneal soft tissue sarcoma:an analysis of radiation and surgical treatment[J].Int J Radiat Oncol Biol Phys,2007,67(1):158-63.