肝脏炎性肌纤维母细胞瘤的CT、MRI表现

CT and MRI findings of hepatic inflammatory myofibroblastic tumor

目的探讨肝脏炎性肌纤维母细胞瘤(HIMT)的影像表现,提高对该病的诊断水平,减少误诊。方法回顾性分析2018年5月至2021年9月收治并经手术病理确诊的5例HIMT患者临床及影像资料,均行CT及MRI检查,2例加行免疫组化检查。分析患者的影像表现。结果共发现6枚病灶,其中1例为多发。4例行CT平扫,病灶均呈软组织密度,呈圆形、类圆形或不规则形。5例行MRI平扫,6枚病灶均呈T_(1)加权成像(T_(1)WI)稍低信号、T_(2)加权成像(T_(2)WI)稍高信号。5枚病灶实性成分均呈延时强化;1枚病灶周边见环形低密度/信号带,延迟期低密度/信号带可见强化;3枚病灶呈花环样强化,其中2枚病灶伴分隔样强化;1枚病灶边缘薄环样强化伴明显分隔样强化;1枚结节呈全瘤强化型;1枚病灶内见“挂果征”。结论HIMT有一定的特征性影像学表现,结合CT、MRI平扫和增强扫描及实验室检查结果综合分析可提高诊断准确率。

Objective To investigate the imaging findings of hepatic inflammatory myofibroblastic tumor(HIMT),so as to improve the diagnosis of the disease and reduce misdiagnosis.Methods The clinical and imaging data of 5 HIMT patients admitted from May 2018 to September 2021 and confirmed by surgery and pathology were retrospectively analyzed.All patients underwent CT and MRI examination,and 2 patients underwent immunohistochemical examination.The imaging findings of the patients were analyzed.Results A total of 6 lesions were found,of which one was multiple.CT plain scan was performed in 4 cases,and the lesions were soft tissue density,round,round-like or irregular.MRI plain scan was performed in 5 cases,and 6 lesions showed slightly low signal on T_(1) weighted imaging(T_(1)WI)and slightly high signal on T_(2) weighted imaging(T_(2)WI).The solid components of 5 lesions showed delayed enhancement;1 lesion showed annular low density/signal band around the lesion,and the low density/signal band showed enhancement in the delayed phase;three lesions showed wreath-like enhancement,including 2 lesions with septate enhancement;there was thin ring-like enhancement of the edge of 1 lesion with obvious separation-like enhancement;1 nodule showed whole tumor enhancement;the"hanging fruit sign"was found in 1 lesion.Conclusion HIMT has certain characteristic imaging findings.Combined with CT,MRI plain scan and enhanced scan and laboratory examination results,the diagnostic accuracy can be improved.