结节性筋膜炎的影像诊断与临床分析

Imaging features and clinical analysis of nodular fasciitis

目的:探讨结节性筋膜炎(NF)的超声和MRI表现,以提高影像诊断水平,为临床治疗提供依据。方法:回顾性分析经病理证实的17例NF患者,13例行超声检查,4例行MRI检查。结果:17例中,11例位于上肢,1例位于下肢,2例位于颈部,1例位于胸壁,1例位于腹壁,1例位于乳腺。病灶最大径0.4~3.2 cm,平均(1.5±0.7)cm。行超声检查13例中,11例病灶以低回声为主,4例低回声病灶内伴片状高回声,3例低回声病灶内同时伴片状高回声和无回声区;7例病灶后方回声增强;行CDFI 8例中,3例病灶内见少量血流信号。4例MRI检查示:病灶在T1WI呈等、略低信号;T2WI呈高信号,其中1例病灶见囊变区,3例病灶周围见水肿信号。结论:NF的超声和MRI表现有一定的特征性,均有助于该病的诊断和鉴别诊断。

Objective:To explore the ultrasound and MRI features of nodular fasciitis to improve the quality of diagnosis.Methods:The ultrasound and MRI data were retrospectively analyzed in 17 patients with nodular fasciitis confirmed by pathology.Thirteen patients underwent ultrasound examination and the other 4 patients underwent MRI scan.Results:Of the 17 cases,11 cases were located in the upper extremity,one case in the lower extremity,two cases in the neck,one case in the chest wall,one case in the abdominal wall,and one case in breast.The tumor sizes varied from 0.4 to 3.2 cm in the largest diameter and the mean diameter was(1.5±0.7)cm.In 13 cases with ultrasound examination,11 cases were mainly hypoechoic,4 cases were hypoechoic,accompanied by hyperechoic patches,3 cases were hypoechoic,accompanied by hyperechoic patches and anechoic area and 7 cases showed posterior echo enhancement.In 8 cases with CDFI examination,there was a small amount of blood flow signal in the lesions in 3 cases.Four patients underwent MRI scan and the lesions showed iso-or mildly hypo-intense signal on T1WI,and hyperintense signal on T2WI,including one case with cystic area,and 3 cases with edema signal around the lesions.Conclusion:Ultrasound and MRI findings of nodular fasciitis have certain characteristics,which are helpful to improve the diagnosis and differential diagnosis of this disease.