儿童炎性肌纤维母细胞瘤的超声及磁共振成像特征分析

Characteristics of ultrasound and magnetic resonance imaging of inflammatory myofibroblastic tumor in children

目的探讨儿童炎性肌纤维母细胞瘤(IMT)的超声及磁共振成像(MRI)特征。方法回顾性分析郑州大学附属儿童医院2016年2月至2021年3月经手术及病理确诊的17例儿童炎性肌纤维母细胞瘤患者的超声、MRI影像学资料及临床资料。结果17例IMT中发生在腹腔内5例,肠腔内4例,腹膜后3例,肺部2例,盆腔2例,肝脏2例(其中1例与腹膜后同时出现)。超声表现:包块均为边界较清晰的实性低回声团,少部分伴有囊腔,具有较典型的占位效应,内回声不均匀,少数为多部位发生病变,彩色多普勒血流显像内可见血流信号。MRI表现为T1加权像等低、T2加权像高低混杂信号,边缘伴低信号环,弥散加权成像呈高低混杂信号。结论儿童IMT的超声及MRI表现具有一定的特征性,占位呈实性或伴有小囊腔的囊实性包块。超声简便、快捷、无创,可作为IMT诊断及术后随访的首选影像学检查,MRI可作为进一步的影像学诊断方法,但金标准仍是病理及免疫组织化检查。

Objective To investigate the characteristics of ultrasound and magnetic resonance imaging(MRI)of inflammatory myofibroblasttic tumor(IMT)in children.Methods The ultrasound,MRI imaging,and clinical data of 17 children with IMT diagnosed by surgery and pathology in the Children’s Hospital Affiliated to Zhengzhou University from February 2016 to March 2021 were analyzed retrospectively.Results Among the 17 cases of IMT,5 cases occurred in the abdominal cavity,4 cases in the intestinal cavity,3 cases in the retroperitoneum,2 cases in the lung,2 cases in the pelvic cavity and 2 cases in the liver(1 case occurred simultaneously with the retroperitoneum).The ultrasound imaging data of tumors showed that solid hypoechoic masses with clear boundaries,a few tumors accompanied by cystic cavity,typical space occupying effect,the uneven internal echo,a few patients with lesions in multiple parts,and visible blood flow signals in color Doppler flow imaging.MRI showed mainly low signal on T1 weighted image,mixed signal on T2 weighted image,low signal ring on the margin,and mixed signal on diffusion weighted imaging.Conclusions The ultrasound and MRI manifestations of IMT in children have certain features,including the space occupying lesions or solid cystic masses accompanied by small cavity.Ultrasound is simple,fast and noninvasive,it can be used as the preferred imaging examination for the diagnosis and postoperative follow-up of the disease.MRI can be used as a further imaging diagnosis method,but the definite diagnose still depends on pathological and immunohistochemical examination.