肝脏炎性肌纤维母细胞瘤的多层螺旋CT及MRI表现

Imaging manifestation of MSCT and MRI in hepatic inflammatory myofibroblastic tumor

目的探讨肝脏炎性肌纤维母细胞瘤(HIMT)的多层螺旋CT(MSCT)及MRI影像特点。方法回顾性分析2015年2月至2017年11月乐山市人民医院经手术病理证实的6例HIMT,术前2例行MSCT平扫,4例行MSCT平扫+增强扫描,4例行MRI平扫+增强扫描,CT未增强者均行MRI平扫+增强扫描,对患者肿瘤的部位、大小、密度/信号、形态、囊变、强化程度和方式进行评估。结果 6例HIMT患者MSCT显示均为稍低密度,MRI信号不均匀;5例动脉期边缘模糊强化,1例无明显强化,6例门脉期及延迟扫描期均有明显强化。结论 MSCT及MRI成像均能够明确显示HIMT的形态学改变、强化程度及方式,MRI多序列成像更能初步判断肿瘤内部的可能构成成分,尤其是病灶内部坏死区在T2WI压脂序列呈低信号对诊断更有重要参考价值。

Objective To investigate the imaging manifestation value of multislice CT（MSCT） and magnetic resonance imaging（MRI） in hepatic inflammatory myofibroblastic tumor（HIMT）. Methods Six cases of HIMT were successfully diagnosed by histopathologic examination from February 2015 to November 2017 in People’s Hospital of Leshan. We retrospectively analyzed the clinical features of the cases. Two cases were examined by plain CT scan, four by plain CT scan and enhanced CT scan, four by plain MRI scan and enhanced MRI scan. Enhanced MRI scan was done for all plain CT to analyze tumor location, size, density/signal, shape, presence of cystic, degree and pattern of enhancement. Results All the six HIMT cases showed low density in MSCT and uneven in MRI, five cases with blur enhanced edge in arterial phase and one case had no obvious enhanced in arterial phase, while the portal and delayed scanning was significantly enhanced. Conclusions MSCT and MRI imaging can clearly display the morphological changes, the degree and patterns of enhancement of the lesions of HIMT. MRI multisequence imaging can be used to determine the possible components of the lesions, especially the necrosis inside the lesions with low signal in T2 WI-fat saturation, which has important reference value for accurate diagnosis.