腹部炎性肌纤维母细胞瘤的影像表现

The Imaging Manifestations of Abdominal Inflammatory Myofibroblastic Tumor

目的探讨腹部炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT)的CT、MRI表现,旨在提高对其诊断水平。资料与方法回顾性分析经手术病理证实的6例腹部IMT患者的临床及影像学资料。其中男、女各3例,年龄1～61岁,平均35.5岁。5例行CT扫描,其中4例行平扫及增强扫描,1例仅行平扫;1例行MRI平扫及增强扫描。结果肠系膜4例,横结肠1例,前列腺后方1例。5例为单发病灶,1例为多发病灶,部分相互融合。4例边界清晰,2例不清晰。病灶最大横径5.3～15.4cm。CT平扫4例密度均匀,1例密度不均匀,CT值25～58HU;增强扫描3例呈明显强化,其中不均匀强化2例,均匀强化1例,1例呈轻度均匀强化,2例强化病灶内及周边可见血管影。1例MRI表现为边界清晰的软组织肿块,实性部分T1WI呈等信号,T2WI呈稍高信号,中心可见不规则黏液样变性,呈明显短T1、长T2信号,增强扫描病灶实性部分呈明显均匀强化,黏液样变性区无强化。结论 CT、MRI能清楚显示IMT的部位、大小及其与周围组织的关系,但表现无特异性,确诊仍依赖病理检查。

Objective To investigate the CT and MRI manifestations of abdominal inflammatory myofibroblastic tumor （IMT） and improve its diagnostic accuracy.Materials and Methods Imaging and clinical data of 6 cases with IMT proved by pathological results were analyzed retrospectively.3 males and 3 females,aged from 1 to 61 years,mean age 35.5 years.5 cases were performed with CT plain scan,in which 4 cases with contrast medium enhancement,1 case had plain scan only.1 case received MRI scan with contrast medium enhancement.Results The anatomic locations included mesenterium（n=4）,colon transversum （n=1） and back of prostate （n=1）.5 cases were single lesion,1 case was multiple and confertus lesions.4 cases had clear border,2 cases had unclear margin.The maximum diameter of the lesion was 5.3-15.4 cm.CT plain scan in 4 cases showed even density,CT value from 25 to 58HU,1 case was uneven.3 cases were significantly enhanced,including non-homogeneous enhancement of 2 cases,1 case with homogeneous enhancement.1 case presented mild and homogeneous enhancement.2 lesions were seen within and around blood vessels enhancement.1 case had MRI scan and showed soft tissue mass with clear border,the solid part of the lesion showed isotensity signal on T1WI,T2WI showed a slightly hyperintensity signal,the center area showed irregular mucinous degeneration,which displayed significantly hyperintensity in both T1WI and T2WI.After contrast administration,solid part of the lesion displayed homogeneous enhancement,mucinous degeneration region showed no enhancement.Conclusion CT and MRI imaging clearly demonstrate the location and relationship with the surrounding structures of IMT.The final diagnosis relies on pathology examination.