腹盆腔脏器炎性肌纤维母细胞瘤的CT表现

CT Imaging Features of Inflammatory Myofibroblastic Tumors of Abdominal and Pelvic Organs

目的探讨腹盆腔脏器炎性肌纤维母细胞瘤(inflammatory myofibroblastic tumor,IMT)的CT表现,以提高诊断准确率。方法回顾性分析10例经病理证实的腹盆腔脏器IMT的临床及影像学资料,10例患者均行CT平扫及增强扫描。结果 10例IMT中,肝脏6(6/10)例,表现为类圆形(3例)、团块状2(例)及不规则形(1例)低密度影,边界清(2例)或不清(4例);增强扫描动脉期无明显强化2例,轻-中度强化4例;门脉期中-重度强化6例;延迟期持续性强化5例,强化程度下降1例。脾脏2(2/10)例,边界清,密度均匀(1例)或不均(1例),增强扫描均呈轻-中度持续性强化。右肾1(1/10)例,呈囊实性,边界模糊,增强扫描呈厚壁环形强化。膀胱1(1/10)例,呈宽基底与膀胱壁相连,密度不均,表现为不均匀轻-中度持续性强化。结论腹盆腔各脏器IMT的CT表现有一定的特异性,结合临床资料,应考虑到本病的可能;但最终确诊仍依赖于病理和免疫组织学检查。

Objective To improve the diagnostic accuracy by investigating the CT imaging features of inflammatory myofibroblastic tumors (IMT) of abdominal and pelvic organs.Methods The clinical and CT imaging findings of 10 patients with pathologically proved IMT were enrolled.The 10 cases all had pre-and post-contrast CT imaging.Results Among 10 cases,6(6/10) cases located in liver showed round (n=3),phymatoid (n=2) or irregular (n=1) hypodensity mass with clear (n=2) or unclear (n=4) margin.Enhanced manifestations in dynamic contrast scan showed no enhancement (n=2) or mild / moderate enhancement (n=4) in arterial phase.Continuous enhancement was showed in the portal phase (n=6) and delayed phase (n=5).Otherwise,1case showed wash-out corresponding to the arterial phase image.2(2/10) cases located in spleen were homogeneous (n=1) or heterogeneous (n=1) iso/hypodensity with defined margin (n=2).Both of them showed mild to moderate and delayed enhancement.1(1/10) case located in right kidney was cystic-solid mass with obscure boundary and showed thick wall enhancement.1(1/10) case located in bladder had heterogeneous hypodensity with broad base,which showed mild to moderate and heterogeneous delayed enhancement.Conclusion IMT of abdominal and pelvic organs have certain CT imaging features.Associated with its clinical data,we should realize the possibility of IMT.However,the final diagnosis still relies on pathology and immunohistochemistry examination.