儿童肌纤维瘤的影像学表现

Imaging features of myofibroma in children

目的:分析儿童肌纤维瘤的影像学表现,提高对此病的诊断水平。方法:回顾性分析本院2010年1月-2020年5月经手术病理证实的16例肌纤维瘤患儿的病例资料。12例行CT平扫,其中9例行CT增强扫描,5例行MRI平扫,其中4例行MRI增强扫描。观察分析肌纤维瘤的部位、数目、大小、形态、边界、有无骨侵犯、密度/信号和强化方式等征象。结果:16例共检出32个病灶,其中2例为多发病灶(分别有6和12个)。发病部位:头颈部6例,四肢5例,躯干2例,骨内2例(其中1例为多发),1例累及四肢、躯干等多部位;孤立性肿块14例,多中心性病变2例;9例呈类圆形,7例呈不规则形;5例边界清晰,11例边界模糊;2例骨质受侵犯。8例CT平扫呈低或稍低密度,1例呈稍高密度,3例呈混杂密度;CT增强扫描显示5例呈轻度不均匀强化,4例呈明显不均匀强化。MRI平扫T_(1)WI上3例呈等~低信号,2例呈等~稍高信号;T_(2)WI上4例呈高~低混杂信号,1例呈稍高信号;4例MRI增强呈明显不均匀强化。随访中有2例复发。结论:儿童肌纤维瘤是一种罕见的软组织肿瘤,其CT及MRI表现具有一定的特征性。

Objective:The purpose of this study was to analyze the imaging features of myofibroma in children,so as to improve the diagnosis level of this disease.Methods:The data of 16 children with myofibroma confirmed by surgery and pathology from January 2010 to May 2020 in Hunan Children's Hospital were analyzed retrospectively.12 cases underwent plain CT scan,of which 9 cases underwent contrast enhanced(CE)-CT scan;5 cases underwent MRI plain scan,of which 4 cases underwent CE-MRI scan.The location,number,size,shape,boundary,bone invasion,density/signal and enhancement of myofibroma were observed and analyzed.Results:A total of 32 lesions were detected in 16 cases of myofibroma,including 2 cases with multiple lesions(6 and 12 lesions,respectively).The lesions located in head and neck in 6 cases,in limbs in 5 cases,in trunk in two cases,in bone in 2 cases(including one case with multiple lesions),and one case had multiple lesions located in limb and trunk.14 cases had solitary mass,and 2 had multicentric lesions;round mass was found in 9 cases,and irregular mass in 7 cases;clear border in 5 cases and blurred boundary in 11 cases;2 cases had bone invasion.On plain CT images,8 cases showed low or slightly low density,one case showed slightly high density,and 3 cases showed mixed density.On CE-CT scan,5 cases showed slightly uneven enhancement,4 cases showed significantly uneven enhancement.On MR T_(1)WI,3 cases showed equal or low signal,2 cases showed equal high signal;and on T_(2)WI,4 cases showed high and low mixed signal and one case showed slightly high signal;on CE-MRI scan,4 cases showed significantly uneven enhancement.In follow-ups after operation,tumor recurrence was found in 2 cases.Conclusion:Children's myofibroma is a rare soft tissue tumor with certain characteristic CT and MRI findings.