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目的探讨原发性骨恶性纤维组织细胞瘤(PBMFH)的影像学改变,以及X线平片、CT及MRI不同影像学检查方法的应用价值。方法总结经病理证实的35例(PBMFH)的影像学表现,回顾性分析X线平片、CT及MRI的影像学特征,探讨其对(PBMFH)的诊断价值。结果(PBMFH)具备全部恶性骨肿瘤的影像学特征,表现呈多种多样。X线平片和CT常表现为偏心性、侵袭性、溶骨性长骨端骨质破坏,并伴超过溶骨破坏范围的软组织肿块,骨膜反应少见。MR影像改变以等T1、等T2信号为主,其中夹杂斑片状、囊状长T1、长T2信号,但缺乏特异性。结论X线平片是首诊骨肿瘤的主要手段;CT及MRI检查的价值则在于显示病灶范围、皮质破坏、内部坏死及致密残留骨或钙化等骨和软组织细微结构变化情况,特别是MRI还可作为监测病变化疗、放疗疗效及术后复发的重要手段。
Objective To investigate the imaging changes of primary malignant fibrous histiocytoma (PBMFH) and the application value of different imaging methods of X-ray, CT and MRI. Methods The imaging findings of 35 cases (PBMFH) confirmed by pathology were summarized. The radiographic features of X-ray, CT and MRI were retrospectively analyzed to evaluate the diagnostic value of PBMFH. The results (PBMFH) with all malignant bone tumor imaging features, the performance was varied. X-ray and CT often showed eccentricity, aggressive, osteolytic long bone end bone destruction, with more than the scope of osteolytic destruction of soft tissue mass, periosteal reaction rare. The changes of MR images were mainly T1, T2, etc., with patchy and long cystic T1 and T2 signals, but lack of specificity. Conclusions X-ray film is the main method for the first diagnosis of bone tumors. The value of CT and MRI examination is to show the changes of lesion, cortical destruction, internal necrosis and fine bone or soft tissue such as residual bone or calcification, especially MRI Can be used as monitoring lesion chemotherapy, radiotherapy and postoperative recurrence of an important means.