MSCT在肺部炎性肌纤维母细胞瘤诊断中的应用

Multi Slice Spiral CT in Diagnosis of Pulmonary Inflammatory Myofibroblastic Tumor

目的:探讨MSCT在肺部炎性肌纤维母细胞瘤诊断中的应用价值。方法:选取我院2011年1月-2018年1月收治的疑似肺部炎性肌纤维母细胞瘤患者87例,选取患者仰卧位,采用飞利浦64层CT扫描仪检查。结果:95.40%均为单发肿瘤,4.6%多发肿瘤。15.66%位于左肺上,22.89%位于左肺下,27.71%位于右肺上,33.73%位于右肺下。4例多发肿瘤中50.00%位于肺外部, 50.00%位于纵膈旁,最小病灶1.2cm,最大病灶5.34cm。87例患者得肿瘤病灶形态多样,趋于恶性肺癌形态,其中椭圆形居多有51.72%,不规则形态11.49%、类圆形23.00%、菱形13.79%。征型有13.79%为轻度浅分叶状,26.44%桃尖征,16.09%内见空洞,26.44%边缘模糊不清,5.75%毛玻璃影,13.79%长毛刺征,其中5.75%病灶内侧缘与肺内之间有牵拉索条。病理诊断发现13.79%肿瘤细胞内有塑性纤维母细胞排列,炎性细胞浸润,出现纤维增生。大部分肿瘤患者得病灶密度不均,16.09%病灶表现为低密度区,17.24%病灶内出现支气管充气征,26.44%见肺动脉穿行病灶内,仅有5.75%病灶密度均匀,12.64%病灶内见多发钙。强化CT值最高为126HU,病灶周围出现部分强化程度高于中心区。结论:MSCT是诊断肺部炎性肌纤维母细胞瘤的有效方法,分析其影像学特点能提高检出率及正确性。

Objective:To investigate the application effect of multi slice spiral CT(MSCT) in diagnosis of pulmonary inflammatory myofibroblastic tumor.Methods:87 patients with suspected pulmonary inflammatory myofibroblastoma from January 2011 to January 2018 were selected. The patients were supine and examined by Philips 64-layer CT scanner.Results:95.40% were single tumors and 4.6% had multiple tumors. 15.66% were in the left upper lung, 22.89% in the left lower lung, 27.71% in the right upper lung, and 33.73% in the lower right lung. 50.00% of the 4 multiple tumors were located outside the lung, 50.00% were located next to the mediastinum, the smallest lesion was 1.2 cm, and the largest lesion was 5.34 cm. 87 patients had tumor lesions with various forms and tend to be malignant lung cancer, the proportions of elliptic shape, irregular shape, round shape and diamond shape were 51.72%, 11.49%, 23.00%, and 13.79%, respectively. 13.79% of the traits were mild shallow lobulated, 26.44% were apex, 16.09% were hollow, 26.44% were blurred, 5.75% were ground glass, 13.79% were long burr, and of 5.75% having a pulling strip between the medial edge and the lung. Pathological diagnosis showed that 13.79% of the tumors had plastic fibroblasts arranged, inflammatory cells infiltrated, and fibrosis. Most of the tumors showed uneven density, 16.09% showed low density area, 17.24% showed bronchial inflation sign, 26.44% saw pulmonary artery passing through the lesion, only 5.75% had uniform density, 12.64% had multiple calcium. The highest CT value was 126 HU, and the degree of enhancement was higher than that in the central area.Conclusion:MSCT is an effective method for diagnosing pulmonary inflammatory myofibroblastic tumors. Analysis of its imaging features can improve the detection rate and accuracy.