毛母质瘤的影像表现与病理对照分析

Comparative analysis of CT and MRI findings and pathology of pilomatricoma

目的:对照分析毛母质瘤的CT、MR影像特点与病理表现。方法:回顾性分析经病理确诊为毛母质瘤28例(30个病灶)患者的CT、MR表现,并与其病理学表现进行对照分析。结果:毛母质瘤28例患者,其中经CT检查24例(25个病灶),22个病灶主要表现为钙化,占88%(22/25),肿瘤周围条索影;经MR检查6例(7个病灶),病灶与同侧面骨骼肌相比,T1WI均呈等信号,T2WI以等-偏高信号为主,所有的病灶周围见条索状稍高信号;28例(30个病灶)病理标本内均可见不同程度的钙化,CT显示88%的病变内有钙化;MR T2WI显示肿块边缘的环形高信号与病理上的结缔组织包膜对应;肿瘤周围的炎性反应63.33%(19/30),CT表现为肿瘤周围条索影,MR表现肿瘤周围条片样长T2信号,边界欠清;肿块中央区的CT液体密度区及MR长T1长T2信号区与病理的囊性变区域相对应。结论:当肿块在CT表现上为有不同程度钙化的、边界清楚的椭圆形或类圆形结节,MRI T2WI表现为不均匀等或偏高信号,边缘可见环形稍高信号包膜及周围的炎性稍高信号的结节或肿块时诊断需考虑有毛母质瘤的可能。

Objective: To analyze the CT and MRI manifestations and pathological characteristics of the pilomatricoma.Methods: Twenty-eight children were diagnosed as pilomatricoma, whose CT and MRI findings and pathological results were retrospectively analyzed. Results: Twenty-five lesions were detected by CT in 24 patients, in which calcification was the main manifestation. Seven lesions were detected by MRI in six patients. Compared to skeletal muscle on the sides, all lesions showed equal signal on T1 weighted image(T1 WI), while high signal on T1 weighted image(T2 WI). Pathological findings showed calcification in all lesions, and CT showed calcification in 88%(22/25 cases). The circular high signal at the margin of mass on MRI corresponded to the connective tissue capsule on pathological findings. In the central area of the tumors, the liquid density on CT and the long T1 long T2 signal on MR corresponded to the histological cystic structure on pathological findings.Conclusion: CT features of pilomatricoma are calcification in var degrees. MRI features of pilomatricoma include heterogeneous or slightly hyperintense, with circular slightly hyperintense envelope and surrounding inflammatory slightly hyperintense nodules or masses on T2 WI.