肝脏炎性肌纤维母细胞瘤的影像学表现与病理分析

Hepatic Inflammatory Myofibroblastic Tumor: Imaging Findings with Pathologic Correlation

目的探讨肝脏炎性肌纤维母细胞瘤(HIMT)的影像学表现及病理特点,提高对该病的认识和诊断准确性。资料与方法回顾性分析经病理证实的21例HIMT患者的影像学表现与病理特点。21例均行CT检查,其中3例同时行MR检查。结果 21例病灶均位于肝右叶,平均直径(4.1±1.2)cm。平扫CT均为低密度影;T1WI为低信号,T2WI为等或稍高信号;动态增强扫描强化表现:全瘤强化型8例,边缘强化型6例,分隔强化型4例,无强化型3例;除无强化型外,其余18例动态增强均表现为动脉期轻度强化,门静脉期明显强化,延迟期仍见强化。所有病灶镜下均见不同程度的凝固性坏死、纤维组织增生及炎症细胞浸润。结论 HIMT的CT及MR表现多样,动态增强以门静脉期及延迟期强化为主,其中全瘤强化型较具特征性;HIMT的影像学表现充分反映其病理特点,结合临床有助于及时作出正确诊断。

Purpose To evaluate the imaging findings with clinical features and pathological basis of hepatic inflammatory myofibroblastic tumor （HIMT）. Materials and Methods Twenty-one patients with pathology proven HIMT were reviewed retrospectively. Twenty-one patients underwent CT, and three underwent additional MRI. Results All tumors in 21 patients were in right hepatic lobe. The mean diaineter was （4.1 ± 1.2） cm. The lesions were low density on non contrast CT. MRI was manifested as hypointense lesions on unenhanced TlWl and isointensity or mild hyperintensity on unenhanced T2WI. Enhancement manifestations in dynamic contrast scan showed 8 cases of entire tumor enhancement, 6 ring-shaped enhancement： 4 septal enhancement; 3 no enhancement. Pathological examination showed different degrees of organized necrosis, fibrous tissue and inflammatory cells infiltration. Conclusion The CT and MRI features of HIMT are characteristic, which correlate with its pathological findings.