, ANG ,

(1.Department of Radiology, Henan Province Rongjun Hospital, Xinxiang 453003, China;2.CT Division, Zhengzhou People's Hospital, Zhengzhou 450003, China)



Imaging features of dermatofibrosarcoma protuberan

LIJiacai1*,LIANGJinwen1,QIPeihong2

(1.DepartmentofRadiology,HenanProvinceRongjunHospital,Xinxiang453003,China;2.CTDivision,ZhengzhouPeople'sHospital,Zhengzhou450003,China)

ObjectiveTo investigate the image features of dermatofibrosarcoma protuberan (DFSP). MethodsImages of 9 cases with DFSP were reviewed, and the CT, MR images and pathological appearances were observed. ResultsAll cases were solitary mass, located in skin or subcutaneous tissue; 4 cases located in the limbs, and the others were in the trunk. Eight cases were subcutaneous soft tissue masses, and 6 cases manifested as round or oval with clear boundary, 2 cases with lobulated shape grow into muscular septum, 1 case had indistinct boundary; 1 case was outside the skin with overhanging and lobulated. Two cases of CT scan displayed moderate slightly low density with uniform or slightly uneven. The mass of 7 cases showed even equal or low signal and 1 case showed uneven high signal on T1WI, and 6 cases showed uneven high signal accompanying plaque-like low or high T2 signal region, and 2 case showed high signal of which 1 case with circle low signal region on T2WI. All 5 cases displyed obviously enhanced, but 4 cases were unevenly enhanced association with plaque-like low signal region. ConclusionImaging features of DFSP have some characteristics, and MRI is valuable to etiologic diagnosis and preoperative evaluation.

Dermatofibrosarcoma protuberan; Magnetic resonance imaging; Tomography, X-ray computed; Pathology

隆突性皮肤纤维肉瘤(dermatofibrosarcoma protuberan, DFSP)为发生于皮肤和皮下纤维组织的交界性或低度恶性肿瘤，浸润生长能力很低，极少发生转移，其发病率低，占全身所有软组织肉瘤的1.8%[1-2]。临床DFSP常表现为无痛性皮肤或皮下肿块，生长缓慢，常易被误诊为良性肿瘤而因切除范围不足导致复发。笔者收集经病理证实的皮肤隆突性纤维肉瘤患者9例，探讨其影像学表现特点，以提高其诊断准确性。

1　资料与方法

1.1一般资料收集 2010年5月—2015年7月经病理证实的DFSP患者9例，其中男6例，女3例，年龄24～75岁，中位年龄47岁。临床表现为可触及的浅表肿块，局部隆起，生长缓慢，病程3个月～15年，3例逐渐出现刺痛感、压痛，2例术后原位复发。9例患者中对8例行MR平扫，其中5例同时行MR增强检查；2例行CT平扫。

1.2仪器与方法MR检查：采用GE Signa Excite 1.5T或GE Signa HDX 3.0T超导MR扫描仪，根据发病部位采用不同的线圈，平扫行轴位、冠状位、矢状位扫描，采用SE T1W(TR 440～700 ms，TE 7～20 ms)、T2W(TR 3 300～4 500 ms，TE 54～132 ms)、脂肪抑制短时反转恢复(TR 3 000～4 200 ms，TE 90～137 ms)序列；增强扫描采用SE T1W序列(TR 440～700 ms，TE 7～20 ms)，对比剂采用Gd-DTPA，剂量0.2 ml/kg体质量。

CT检查：采用Philips Brilliance 16排CT机，管电压120 kV,管电流100 mAs，层厚5 mm,重建层厚2.0 mm。

1.3病理检查术后对所取标本进行常规HE染色及免疫组化检查，免疫组化项目包括CD34、肌动蛋白(Actin)、S-100蛋白。

2　结果

9例均为单发病灶，均发生于皮肤或皮肤下，其中四肢4例(小腿1例，大腿2例，上臂1例)、躯干5例(右侧颈根部锁骨上方1例，肩部1例，腹壁1例，腰背部1例，臀部1例)。6例呈圆形或类圆形，呈皮下软组织肿块，其中5例病灶部分边界与皮肤接触，且3例伴邻近皮肤增厚，2例沿皮下呈舌状突出生长，肿瘤最大径25～76 mm，边缘较清晰(图1、2)；3例……