小儿炎性肌纤维母细胞瘤CT/MRI表现分析

Analysis of CT/MRI features of pediatric inflammatory myofibroblastic tumor

目的:回顾分析17例儿童炎性肌纤维母细胞瘤的CT/MRI影像学表现,以提高对本病的特异影像表现认识。方法:搜集复旦大学附属儿科医院及浙江大学附属儿童医院2010年2月-2014年5月由病理确诊的炎性肌纤维母细胞瘤17例。17例中术前行多排螺旋CT平扫及增强检查15例,行B超检查5例,行MRI平扫及增强检查5例,仅行MRI平扫检查3例。不能配合的患儿检查前采用10%水合氯醛0.5mL/kg口服镇静。结果:本组17例炎性肌纤维母细胞瘤的发生部位包括头顶部1例,颈部2例,肺部2例,肝脏2例,胃壁2例,胰腺2例,后腹膜1例,结肠1例,膀胱3例,直肠1例。17例病例影像学均表现为占位性病变,边缘不清,密度/信号不均匀,部分病灶内有钙化,位于肿块中央较多;增强后病灶均可见显著不均匀强化,边缘强化为主。17例病例中13例完整切除肿瘤,3例行肿瘤活检术,1例行肿块部分切除术,1例活检病例在术后6个月随访CT检查发现腹腔多发软组织肿块。病理均明确诊断。结论:儿童炎性肌纤维母细胞瘤CT/MRI表现特征包括钙化、增强显著和边界不清楚等特点,尤其是边缘强化较显著的特征,与其他儿童常见实体瘤有所不同。

Objective：To retrospectively analyze the CT/MRI imaging features in 17 patients with inflammatory myofihrohlastic tumor （IMT）. Methods：Data of seventeen children diagnosed as IMT by surgical pathology were collected from February 2010 to May 2014. All patients sequentially underwent volume computed tomography （VCT） or/and magnetic resonance imaging before surgery. The features of the VCT/MRI of the 1MT were summarized. Results： Among these cases, the tumors were located in different parts of body including head （1/17）, neck （2/17）, lung （2/17）, liver （2/17）,gastric wall （2/17）,pancreas （2/17）,retroperitoneum （1/17）,colon （1/17）,urinary bladder （3/17） and rectum （1/17）. All cases with CT/MRI scans showed space-occupying lesion, with the blurring border and uneven density/signal. Calcification was found in certain lesions, commonly in the center of the mass. Enhanced lesions showed significantly inhomogeneous enhance- ment, with peripheral enhancement predominantly. In 17 cases, 13 cases had complete resection of tumor, 3 cases underwent tumor biopsy,and 1 case received partial tumor resection. In one case with biopsy multiple abdominal soft tissue masses were found in follow-up CT examination 6 months later. Conclusion：CT/MRI features of IMT in children include calcification, enhancement （especially peripheral enhancement） and ill-defined boundary, which are different from other common solid tumors in children.