炎性肌纤维母细胞瘤的MSCT和MRI诊断

Analysis of Multi-slice CT and MRI Manifestations of Inflammatory Myofibroblastic Tumor

目的:探讨炎性肌纤维母细胞瘤(IMT)的MSCT和MRI表现及其临床诊断价值。方法:回顾性分析经手术病理证实的15例IMT患者的CT和MRI表现,其中11例行CT检查,4例行MRI检查。结果:15例中病变发生于腹腔9例、鼻窦和鼻腔1例、肺部2例、左侧腮腺1例、肘关节及膝关节周围各1例。主要CT和MRI表现为肿块密度及信号不均匀,11例出现囊变、坏死,增强后肿块实性部分呈均匀或不均匀中度或明显强化,坏死、囊变区无明显强化,2例关节周围肿块可见包膜。病理示肿瘤由梭形细胞及炎症细胞组成,免疫组织化学染色肌源性蛋白阳性表达。结论:CT和MRI检查对IMT的定位和定性诊断及鉴别诊断具有一定价值,但IMT的确诊有赖于组织病理学及免疫组织化学检查。

Objective：To investigate the multi-slice spiral CT （MSCT） and MRI features of inflammatory myofibro- blastic tumor （IMT） and their value in the clinical diagnosis. Methods：The CT and MRI findings of 15 cases with pathology proven IMT were retrospectively analyzed. Of which, 11 cases had MSCT and 4 cases had MRI. Results：The anatomic locations of tumors in these 15 patients included abdominal cavity （n= 9） ,lung （n= 2） , nasal sinuses and nasal cavity （n= 1 ） , left parotid gland （n= 1）, soft tissue surrounding elbow joint and knee joint for one patient each. The main CT and MRI findings of the tumors were non homogeneous attenuation and signal intensities with moderate or obvious enhancement after contrast injection,cystic and necrotic changes could be seen and without marked enhancement. Capsule could be revealed in the peri-articular soft tissue mass. Tumors were mainly composed of spindle shaped fibrous cells and inflammatory cells on pathology. On immunohistochemistry staining, positive expression of muscle deriving proteins was observed. Conclusion：The final diagnosis of IMT relies on pathology and immunohistochemistry study,multi-slice spiral CT and MRI examination pro vides information of accurate anatomic location and are helpful for the clinical diagnosis and differential diagnosis.