未分化多形性肉瘤与黏液纤维肉瘤的影像学鉴别及预后预测

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-09-25 DOI:10.1016/j.ejrad.2025.112449

Masaya Kawaguchi , Hiroki Kato , Tomohiro Kanayama , Hiroyuki Tomita , Akira Hara , Akihito Nagano , Yoshifumi Noda , Fuminori Hyodo , Masayuki Matsuo

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引用次数: 0

摘要

目的探讨未分化多形性肉瘤（UPS）和黏液纤维肉瘤（MFS）的影像学表现，探讨其复发的预后因素。材料和方法本研究纳入41例经组织病理学和免疫组织化学证实为UPS和MFS的患者。以10%粘液样区作为阈值，组织学上区分MFS和UPS。回顾性检查两种疾病的MRI、CT和18f -氟脱氧葡萄糖- pet /CT结果并进行比较。结果18人有UPS， 23人有MFS。t2加权图像上的主要信号强度UPS为低或中等（89%），而MFS为高（87%,p < 0.01）。肿瘤与肌肉的t2加权图像信号强度比（2.8 vs. 3.8, p < 0.01）和表观扩散系数（ADC）值（0.93 vs. 1.52 × 10-3mm2/s, p < 0.01） UPS低于MFS。CT衰减（37比22 Hounsfield单位，p < 0.01）和最大标准化摄取值（SUVmax）（15.6比5.2,p < 0.01） UPS大于MFS。单因素分析发现，UPS的病理诊断（风险比：15.6）和t2加权图像的低或中等信号强度（风险比：15.7）是复发的预测因素。结论t2加权图像信号强度、ADC值、CT衰减、SUVmax是鉴别UPS与MFS的相关影像学指标。病理诊断和t2加权图像信号强度是复发的预后指标。

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Imaging findings for differentiating and predicting prognosis in undifferentiated pleomorphic sarcoma and myxofibrosarcoma

Objective

This study aimed to examine the imaging findings of undifferentiated pleomorphic sarcoma (UPS) and myxofibrosarcoma (MFS) and identify a prognostic factor for recurrence.

Materials and methods

The research included 41 individuals who histopathologically and immunohistochemically confirmed UPS and MFS. MFS was histologically distinguished from UPS using the 10% myxoid area as the threshold value. MRI, CT, and ¹⁸F-fluorodeoxyglucose-PET/CT results were retrospectively examined and compared between the two diseases.

Results

The results showed that 18 individuals had UPS, whereas 23 had MFS. The predominant signal intensity on T2-weighted images was low or intermediate in UPS (89 %) but high in MFS (87 %, p < 0.01). The tumor-to-muscle signal intensity ratio on T2-weighted images (2.8 vs. 3.8, p < 0.01) and apparent diffusion coefficient (ADC) values (0.93 vs. 1.52 × 10^-3mm²/s, p < 0.01) were lower in UPS than in MFS. CT attenuation (37 vs. 22 Hounsfield Unit, p < 0.01) and maximum standardized uptake value (SUVmax) (15.6 vs. 5.2, p < 0.01) were greater in UPS than in MFS. Univariate analysis found that pathological diagnosis of UPS (hazard ratio: 15.6) and low or intermediate signal intensity on T2-weighted images (hazard ratio: 15.7) were predictors of recurrence.

Conclusion

The signal intensity on T2-weighted images, ADC value, CT attenuation, and SUVmax were relevant imaging results for distinguishing UPS from MFS. The pathological diagnosis and signal intensity on T2-weighted images were prognostic indicators of recurrence.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.