“筋膜征”在CT诊断结节性筋膜炎中的价值

Diagnostic value of the fascial sign in nodular fasciitis with multidetector CT

目的:探讨"筋膜征"在结节性筋膜炎CT诊断中的价值。方法:对12例经手术病理证实为结节性筋膜炎中8例有"筋膜征"患者的临床资料及CT检查资料进行回顾性分析。结果:8例"筋膜征"CT表现为3例沿浅筋膜向皮下脂肪层、2例沿浅筋膜向深部脂肪层、2例沿深筋膜向皮下脂肪层、1例沿深筋膜向骨骼肌群扩展,呈扁平状或椭圆形软组织密度肿块,密度均匀,与周围肌肉密度相比较呈等密度。7例与周围脂肪层及邻近肌肉分界清晰,1例颈部肿块侵及颌下腺及周围颈部肌群;肿块两端筋膜呈线样延伸;肿块与筋膜面平直,不超过筋膜面向反侧侵犯。1例增强扫描肿块明显强化,肿块处筋膜有轻度强化。2例误诊为神经纤维瘤,1例误诊脂肪肉瘤。结节性筋膜炎诊断符合率、敏感度、特异度分别为41.7%、62.5%、70%。结论:CT上"筋膜征"的敏感性、特异性较高,有助于对结节性筋膜炎的诊断。

Objective： To investigate the diagnostic value of the fascial sign in nodular fasciitis with multidetector CT. Methods： 12 patients clinically and pathologically proved nodular fasciitis were retrospetively analyzed.Results： Of the fascial sign in 8 cases,all appeared as flat or oval soft tissue denstity mass. With the superficial fascia to the subcutaneous fat layer in 3,the superficial fascia to the deep layer of fat in 2,the deep fascia to the subcutaneous fat layer in 2,the deep fascia to the sketetal muscle in 1,the linear extension on the fascia of the massive both ends,lumps and fascial surface flat did not exceed the fascia sueface again. The plain CT showed that the density of the lesions was a little bit lower than that of the muscle and significant enhancement appeared after contrast injection（ in 1）. 2 cases were misdiagnosed as neurofibaoma,1 case was misdiagnosed liposarcoma. The fascial sign had diagnosing accuracy of 41. 7%,sensitivity of 62. 5%,and specificity of 70%. Conclusion： The fascial sign is helpful for diagonsing nodular fasciitis.