目的·探讨弥散加权成像（diffusion-weighted imaging，DWI）在隆突性皮肤纤维肉瘤（dermatofibrosarcoma protuberans，DFSP）术前规划中的应用价值。方法·招募2018年5月至2022年3月于上海交通大学医学院附属第九人民医院就诊的DFSP患者。所有患者术前均行CT和MRI检查，且随机分为MRI功能成像组（影像资料包含CT平扫＋增强、MRI平扫＋增强、DWI）与MRI常规成像组（影像资料包含CT平扫＋增强、MRI平扫＋增强）；2组均借助计算机辅助设计软件Medraw，通过CT与对应MRI图像配准［MRI功能成像组与DWI图像配准，MRI常规成像组与动态增强磁共振成像（dynamic contrast-enhanced magnetic resonance imaging，DCE）图像配准］，进行肿瘤边界勾画，形成DFSP三维肿瘤模型，完成皮肤肿瘤三维可视化报告，辅助设计手术切除方案。收集2组患者基本临床资料、随访复发率及术区美观满意度评价情况，并进行组间比较。结果·共招募临床资料及影像资料完善的DFSP患者34例，平均年龄（36.56±13.07）岁，肿瘤发生部位包括腹壁10例、胸壁9例、颌面部4例、大腿及肩部各3例、臀部及腰部各2例、足部1例，肿瘤平均直径为（2.25±0.92）cm。MRI功能成像组和MRI常规成像组各纳入17例患者，2组患者基本临床特征间差异均无统计学意义（均 P>0.05）。所有病例平均随访（9.97±7.82）个月，MRI功能成像组患者肿瘤复发率（0）显著低于MRI常规成像组（29.4%），且MRI功能成像组的术区美观满意率（100%）显著高于MRI常规成像组（70.6%），差异均有统计学意义（均 P<0.05）。结论·DWI对于DFSP肿瘤边界判断较常规MRI更有优势，基于DWI的术前影像规划对降低DFSP复发率及提高术区美观度有一定价值。

Objective ·To explore the value of diffusion-weighted imaging (DWI) in pre-surgical planning of dermatofibrosarcoma protuberans (DFSP). Methods ·The cases with DFSP in Shanghai Ninth People 's Hospital, Shanghai Jiao Tong University School of Medicine from May 2018 to March 2022 were enrolled. CT and MRI were conducted before surgery as a routine procedure. All the patients were randomly divided into MRI functional imaging group (CT plain scan and enhanced scan, MRI plain scan and enhanced scan, and DWI) and MRI conventional imaging group (CT plain scan and enhanced scan, and MRI plain scan and enhanced scan). The tumor boundaries of the two groups were outlined respectively by aligning CT with corresponding MRI images with computer- aided design software Medraw [alignment of CT images with DWI images in MRI functional imaging group and alignment of CT images with dynamic contrast-enhanced magnetic resonance imaging (DCE) images in MRI conventional imaging group] in order to complete the DFSP 3D tumor models and the 3D visualization reports, and to design surgical plans. The clinical characteristics of the two groups were completely collected. The recurrence rate and postoperative satisfaction evaluation of the two groups were compared. Results ·A total of 34 cases with DFSP having completed clinical and imaging information were enrolled in this research with an average age of (36.56±13.07) years. The tumor location of occurrence included 10 cases in the abdominal walls, 9 cases in the chest walls, 4 cases in the maxillofacial regions, 3 cases in the thighs, 3 cases in the shoulders, 2 cases in the hips, 2 cases in the waists, and 1 case in the feet. The average tumor diameter was (2.25±0.92) cm. Seventeen patients were included in the MRI functional imaging group and MRI conventional imaging group respectively with an average follow-up of (9.97±7.82) months. There were no significant differences in the basic clinical information between the two groups ( P>0.05). The recurrence rate of the MRI functional imaging group (0) was lower than that of the MRI conventional imaging group (29.4%), and the postoperative aesthetic satisfaction rate in the former group (100%) was higher than that in the latter group (70.6%). There were statistically significant differences in these results between the two groups ( P<0.05). Conclusion ·DWI is more advantageous for tumor boundary determination compared with conventional MRI; DWI-based preoperative image planning can reduce DFSP recurrence rate and improve aesthetics of the operative area to some extent.