背部弹力纤维瘤影像学表现  

Imaging features of elastofibroma dorsi

作　　者：石建成 吴俊峰 佟桂珍 王东 

机构地区：[1]北京市延庆县医院放射科,北京102100 [2]北京市延庆县医院病理科,北京102100

出　　处：《实用放射学杂志》2013年第9期1472-1474,1502,共4页Journal of Practical Radiology

摘　　要：目的 总结分析背部弹力纤维瘤影像学表现,增强对背部弹力纤维瘤的认识.方法 对本院行手术治疗病理证实为背部弹力纤维瘤的26例患者（男6例,女20例）计28个病灶的影像学表现进行回顾性分析.本组手术26例患者共28个病灶全部经超声检查,其中15例患者同时经胸部CT检查（9例胸部平扫,6例平扫加增强扫描）,3例经MRI检查.结果 本组背部弹力纤维瘤发病部位均位于背部肩胛骨内侧肩胛下角、前锯肌与胸壁间.超声表现为肿块无包膜,以中强回声为主,其内可见索条样高低回声相间排列.回顾15例CT检查中初次诊断6例,漏诊9例,共发现病灶27个（10例临床单侧手术,CT检查发现对侧同位置同性质病灶）,CT表现为扁平椭圆状与肌肉近等密度软组织肿块,其内均可见索条状脂肪密度间隔,脂肪间隔与人体长轴平行.16个病灶前后缘呈毛刷状,内部索条状脂肪与病变前后缘脂肪呈移行,11个病灶前后缘较规则,脂肪间隙清晰.6例增强扫描5例未见明确强化征象同肌肉密度,1例实质期轻度强化.1例双侧病灶内发现点状钙化.3例磁共振检查共发现6个病灶,MRI平扫病灶T1WI及T2WI信号同肌肉信号,DWI无异常信号改变,正反相位有助于其中脂肪间隔检出.结论 背部弹力纤维瘤具有特定发病部位及特殊影像学表现,影像学检查可有效诊断,增强对该病认识可有效减少漏诊.Objective To summary and analysis the image features of elastofibroma dorsi（EFI）） ,and sharpen the identification of it. Methods The image features of 28 masses in 26 patients（6 men ,20 women） with EFD confirmed by pathology after surgical resection were analysed retrospectively. All cases underwent ultrasonography,and 15 patients perforraed CT chest scan , while 6 of them underwent contrast-enhanced CT before surgery, and 3 patients underwent MRI. Results EFD was usually located in the in- frascapular region, between the thorax wall and serratus anterior. On ultrasound, all of cases showed non-enveloped masses, moderate and strong echo with strip-like high-low echo in opposite arrangement. Of all 15 cases, 6 cases were found by CT scan, and 9 ca ses were missed. 27 masses were found by CT scan in 15 patients（in 10 cases, lesions in opposite side were detected by CT scan ）, the CT appearences of them were mainly oval-shaped, muscular-isodensity masses , interlacing with linear streaks of fat-like density along the long axis of human body, the anterior posterior border of 16 masses were like hairhrush and the strip-like fat inside the mass migrated with fat tissue outside the lesion. 11 masses were regularly edged with clear fat interval . Of all 6 cases by enhanced CT scan, 1 case was slightly enhanced,and 5 cases were not enhanced . Punctate calcification were seen in bilateral masses of 1 case. 6 masses were found by MRI scan,they displayed iso-signal like muscle in T1WI,T2WI and DWI,inphase and outphase of MRI contributed to detect linear streaks of fat. Conclusion EFI） should be considered due to their specific location and images features, It can be diagnosed effectively by imaging examination and familiarity with the location and imaging appearances of it may decrease the rate of missed diagnosis.

关 键 词：背部弹力纤维瘤 软组织 计算机体层成像 磁共振成像 

分 类 号：R730.262[医药卫生—肿瘤] R814.42[医药卫生—临床医学]