21例炎性肌纤维母细胞瘤的超声表现分析

Ultrasound manifestations analysis of 21 cases with inflammatory myofibroblastic tumor

目的探讨炎性肌纤维母细胞瘤（IMT）的超声表现，旨在提高对其诊断水平。方法回顾性分析21例经手术病理组织证实的IMT患者超声图像，其中男性13例，女性8例：年龄0.5～76.0岁，平均年龄45.1岁。分析病变的发生部位、大小、形态、边界、内部回声、血流信号及有无转移等特点。仅有5例腹腔IMT和2例盆腔IMT进行增强CT检查，余14例只做了超声检查。结果位于腹腔7例，位于盆腔4例，位于泌尿道2例，位于前臂、颈部、甲状腺、眼眶、阴囊、腹股沟、锁骨下、小腿各1例。13例瘤体最大径〈5cm。8例瘤体最大径〉5cm。14例瘤体边界清楚，7例瘤体边界不清楚。15例瘤体为低回声.6例为囊实混合回声。14例瘤体血流信号不丰富.7例血流信号丰富。仅1例IMT发生腹腔大网膜多发转移，余20例IMT未发现转移灶。免疫组织化学检测显示：肿瘤细胞表达Vimentin、SMA、MSA、Desmin，其阳性率分别为100％（21／21）、100％（21／21）、100％（21／21）、47.6％（10／21）。结论超声检查能清楚显示IMT的部位、大小、形态、边界、内部回声、血流信号及其有无转移等.但超声图的表现无特异性.确诊仍依赖病理学及免疫组织化学检查。

Objective To investigate the ultrasound performance of inflammatory myofibroblastic tumor（IMT）, and improve its diagnostic accuracy. Methods A total of ultrasound imaging of 21 patients with IMT proved by pathological ~results were analyzed retrospectively, included 13 males and 8 females, who were aged 0.5 - 76.0 years old with a mean age of 45.1. The imaging features of location, size, morphology, border, internal echo, blood flow and metastasis were investigated and recorded. Only 5 cases were performed abdominal cavity IMT and 2 pelvic IMT enhanced CT examination, other 14 cases only conducted ultrasound examination without other imaging examinations. Results Seven cases were located in abdominal cavity, 4 cases in pelvic cavity, 2 cases in urinary tract and each one case in forearm, neck, thyroid, orbit, scrotum, groin, infraclavicula and shank, respectively. The maximum diameter of tumor in 13 cases was less than 5 cm, and the maximum diameter of tumor in 8 cases was larger than 5 cm. Fourteen tumors had clear borders, and 7 cases had unclear borders. Fifteen cases were hypo echo, 6 eases were mixed cystic and solid echo. The blood flow of 14 cases were abundant, blood flow of 7 cases was not abundant. Only 1 case IMT had greater omentum metastasis, other 20 cases of IMT had no metastasis. Immunohistochemical showed that tumor cells expressed Vimentin, SMA, MSA and Desmin, the positive rates were 100 % （21/21）, 100 % （21/21）, 100 % （21/21） and 47.6 % （10/21）, respectively. Conclusion It is demonstrated that the ultrasound imaging could clearly show the location, size, morphology, border, internal echo, blood flow and metastasis of IMT, but ultrasound imaging shows no specificity, the final diagnosis relies on pathology and immunohistochemical examination.