肺外炎性肌纤维母细胞瘤CT与MRI表现与病理对照分析

CT and MRI imaging manifestations of extrapulmonary inflammatory myofibroblastoma in relation to pathological findings

目的探讨肺外炎性肌纤维母细胞瘤(IMT)的CT、MRI表现,旨在提高对该病的认识。方法对11例肺外IMT患者行CT与MRI检查,分析表现特征。结果11例肿块均为单发,左侧上颌窦、右侧颌下、左颈部、左上肢、脾脏、右肾各1例,左肾3例,右下肢2例;肿块呈类圆形、椭圆形或不规则分叶状;肿块最大径约1.2~14.9 cm;8例肿块边界清晰,1例周围可见少许渗出,2例周围软组织见片状水肿;呈实性肿块7例,囊实性肿块4例;3例肿块内部可见钙化;增强扫描8例肿块呈轻-中度渐进性/持续性强化,仅1例肿块动脉期呈团块状明显强化。结论肺外IMT缺乏特征性的影像学表现,CT/MRI检查显示实性或囊实性肿块,周围炎性浸润,呈渐进性、持续性强化,需考虑到IMT的可能性,但确诊仍需要依赖病理及免疫组化检查。

Objective To investigate the CT and MRI manifestations of extrapulmonary inflammatory myofibroblastoma(IMT)in order to improve the understanding of this disease.Methods Clinical,pathological and preoperative CT and MRI data of 11 patients with extrapulmonary IMT confirmed by surgical pathology were retrospectively analyzed.Seven patients underwent enhanced CT scan,one underwent both enhanced CT and enhanced MRI scan,one underwent enhanced MRI scan,and two underwent unenhanced MRI.Results The masses in 11 cases were all single,with 1 case in the left maxillary sinus,right submandibular,left neck,left upper limb,spleen,and right kidney,respectively,3 in the left kidney,and 2 in the right lower limb.The mass was round,oval or irregularly lobed,with the largest diameter ranging from 1.2 to 14.9 cm.8 cases had clear borders,1 showed slight exudation,and 2 showed flaky edema in the surrounding soft tissue.7 cases appeared as solid mass and 4 cases manifested as cystic solid mass.Calcification was visible in 3 cases.In contrast-enhanced scan,8 cases showed mild to moderate progressive/continuous enhancement,only 1 case showed obvious bulky enhancement in the arterial phase.Conclusion Extrapulmonary IMT is lack of imaging characteristic.Appearance of a solid or cystic solid mass and progressive and continuous enhancement,with inflammatory infiltration around on CT/MRI examination may indicate the diagnosis of this disease.However,the definitive diagnosis of extrapulmonary IMT depends on pathology and immunohistochemistry.