Lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas): Results of MRI evaluations of 126 consecutive fatty masses
Lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas): Results of MRI evaluations of 126 consecutive fatty masses
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DOI：
10.2214/ajr.182.3.1820733
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发表时间：
2004-03-01
影响因子：
5
通讯作者：
Helms, CA
中科院分区：
文献类型：
--
作者：
Gaskin, CM;Helms, CA
OBJECTIVE.我们的目的是评价MRI在区分单纯脂肪瘤、脂肪瘤变体和高分化脂肪肉瘤（非典型脂肪瘤）方面的可靠性，并识别高分化脂肪肉瘤的各种影像学表现。回顾性分析了126例连续成像的严重脂肪肿块。比较MRI检查、前瞻性解释和相应的病理报告，以确定MRI在区分单纯脂肪瘤、脂肪瘤变体和分化良好的脂肪肉瘤方面的可靠性。MRI在鉴别高分化脂肪肉瘤和其他脂肪肿块方面的成功率如下：敏感性100%，特异性83%，准确性84%，阳性预测值38%，阴性预测值100%。MRI对单纯性脂肪瘤的诊断特异性为100%。63%被认为是高分化脂肪肉瘤的病变实际上是单纯脂肪瘤（13%）和良性脂肪瘤变体（50%），包括软骨样脂肪瘤（13%）、骨脂肪瘤（6%）、冬眠瘤（6%）、脂肪平滑肌瘤（6%）、血管脂肪瘤（6%）和梗死性脂肪瘤（13%）。由于治疗、预后和长期随访的差异，术前区分单纯性脂肪瘤和高分化脂肪肉瘤是很重要的。MRI对高分化脂肪肉瘤的诊断敏感性高，对单纯脂肪瘤的诊断特异性高。然而，当肢体或体壁病变被认为是分化良好的脂肪肉瘤时，它更有可能（64%）代表许多良性脂肪瘤变体之一。
OBJECTIVE. Our objectives were to evaluate the reliability of MRI in distinguishing simple lipomas, lipoma variants, and well-differentiated liposarcomas (atypical lipomas) and to identify various imaging mimics of well-differentiated liposarcoma.MATERIALS AND METHODS. One hundred twenty-six consecutively imaged grossly fatty masses were retrospectively reviewed. MRI examinations, their prospective interpretations, and their corresponding pathology reports were compared to determine the reliability of MRI in distinguishing simple lipomas, lipoma variants, and well-differentiated liposarcomas.RESULTS. The success of MRI in identifying well-differentiated liposarcomas among other fatty masses was as follows: sensitivity, 100%; specificity, 83%; accuracy, 84%; positive predictive value, 38%; and negative predictive value, 100%. MRI was 100% specific in the diagnosis of simple lipoma. Sixty-three percent of lesions considered suspicious for well-differentiated liposarcoma were actually simple lipomas (13%) and benign lipoma variants (50%), including chondroid lipoma (13%), osteolipoma (6%), hibernoma (6%), lipoleiomyoma (6%), angiolipoma (6%), and infarcted lipoma (13%).CONCLUSION. Because of differences in treatment, prognosis, and long-term follow-up, it is important to preoperatively distinguish simple lipomas from well-differentiated liposarcomas. MRI is highly sensitive in the detection of well-differentiated liposarcomas and highly specific in the diagnosis of simple lipomas. However, when an extremity or body wall lesion is considered suspicious for well-differentiated liposarcoma, it is more likely (64%) to represent one of many benign lipoma variants.