摘要
目的探讨炎症性肌纤维母细胞瘤的影像学特征。方法回顾性分析经手术病理证实的5例炎症性肌纤维母细胞瘤患者的影像学资料。5例病变分别来源于颈部间隙、腹膜后间隙、肺脏、上颌窦及肝脏。3例行CT平扫及增强检查,1例行MR平扫及增强检查,1例同时行CT及MR平扫及增强检查。结果病变体积均较大,最小的为48mm×35mm×55mm,最大的为130mm×100mm×90mm,2例恶性,3例偏良性。发生在颈部间隙的病变CT为低密度影,密度较均匀,增强后轻、中度强化,延迟可见持续强化,MR呈等长T1长T2信号,内见少许短T1信号,DWI呈不均匀高信号,增强呈明显不均匀强化,边界不清。腹膜后病变呈多囊性病变,上部为一大囊,囊壁较厚,可见钙化,囊边缘可见实性结节,CT增强后实性结节及囊壁明显持续强化。肺部病变呈软组织密度,其内可见液化坏死区,增强后呈渐进性团块结节样强化,左侧伴有胸腔少量积液。肝脏病灶与肝实质密度相似或稍低,增强后明显不均匀强化,延迟与肝脏密度相似,其包埋肝内血管,同时伴随肝内胆管扩张。上颌窦病变呈等T1混杂等及稍短T2影,DWI呈等及较高信号,增强后明显不均匀持续强化,上颌窦骨壁明显膨胀性破坏。结论炎症性肌纤维母细胞瘤是一种少见的肿瘤,病变体积较大,密度或信号欠均匀,常呈渐进性强化等特点,但其影像学表现缺乏特异性,且不同部位表现不尽相同。CT及MR检查可准确定位,确定周围及邻近浸润及受累情况等,可作为软组织肿瘤定性时的重要鉴别诊断之一。
Objective To study the imaging features of the inflammatory myofibroblastic tumor.Methods To analysis retrospectively the imaging datas of 5 cases of patients with inflammatory myofibroblastic tumor which confirmed by surgery and pathology.5 cases were derived from the retroperitoneal space in the neck,retroperitoneal space,lung,the maxillary sinus and the liver.Plain and Enhanced CT in 3 cases, MR plain scan and enhanced in 1 cases,1 cases underwent plain and Enhanced CT and MR examination. Results Lesion size was large,Sizes from 48 mmx35 mmx55 mm to 130 mmx100 mmx90 mm,2 ca-ses of malignant and 3 cases with benign.The CT plain In the lesions in neck was hypodense with uniform density,and enhanced light-moderate enhancement.Visible delay scan continue to strengthen.As long as MR T1 long T2 signals,enhanced markedly heterogeneous enhancement,but the boundary of the lesion was not clear.Retroperitoneal lesions were cystic lesions which cyst wall is thicker and calcification,and had solid nodule in the wall.In CT enhancement ,the wall continue to strengthen significantly.Pulmonarylesions was soft tissue density,with visible colliquative necrosis area inside the lesion and with p rogressive nodular enhancement in the enhanced examination.The density of the lesions of the liver was similar to or slightly lower than the hepatic parenchymal density and enhanced significantly heterogeneous enhancement,while delayed similar to the density of the liver.The T1WI of the maxillary sinus diseases were mixed and slightly shorter in the T2WI shadow,and enhanced significantly uneven continuous en-hancement.Conclusion Inflammatory myofibroblastic tumor is a rare tumor,having no specificitial ima-ging manifestations,and vary in different parts of the preoperative.So diagnosis is difficult,but CT and MRI imaging can provide lesion location and extent.
出处
《新疆医科大学学报》
CAS
2015年第7期888-892,895,共6页
Journal of Xinjiang Medical University
基金
新疆维吾尔自治区卫生厅青年科技人才专项科研项目(2013Y12)
