MSCT诊断与鉴别诊断支气管腔内肺炎性肌母细胞瘤  

MSCT diagnosis and differential diagnosis of endobronchial inflammatory myofibroblastic tumor

作　　者：吴华超[1] 张杨贵 吴耀初[1] 陈光[1] 李俐倩 符有文[2] 王朝文 

机构地区：[1]广东医学院第二附属医院影像科,广东湛江524003 [2]广东医学院附属医院影像科,广东湛江524001 [3]广东省湛江农垦中心医院影像科,广东湛江524002

出　　处：《中国医学影像技术》2014年第7期1041-1044,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察支气管腔内肺炎性肌母细胞瘤(EIMT)的MSCT表现及其诊断、鉴别诊断价值。方法回顾性分析8例经手术病理穿刺活检证实的EIMT;以45例临床综合诊断或病理证实的支气管腔内常见实性结节样病变作为对照,包括支气管腔内结核10例、支气管腔内纤维瘤5例、支气管腔内平滑肌瘤4例、支气管腔内鳞癌15例、支气管腔内腺癌3例、支气管腔内类癌8例,观察病灶平扫及增强扫描特点。结果 8例IMT中,位于左肺3例(左肺上叶1例,左肺下叶2例),位于右肺5例(右肺上叶1例,右肺中叶1例,右肺下叶3例);病灶位于单或多段支气管及其分支腔内,呈圆形5例、类圆形2例及不规则形1例,平扫密度较均匀;增强后1例病灶呈中等程度强化,其余均呈明显强化及快进慢出型动态强化方式。EIMT最大净增强CT值明显高于支气管腔内结核、支气管腔内纤维瘤、支气管腔内平滑肌瘤、支气管腔内鳞癌、支气管腔内腺癌,明显低于支气管腔内类癌CT值(P均<0.05)。结论平扫MSCT中EIMT不具有特征性表现,MSCT动态增强扫描对其诊断及鉴别诊断具有重要意义。Objective To observe MSCT manifestations of endobronchial inflammatory myofibroblastic tumor （EIMT） and their value of diagnosis and differential diagnosis. Methods Eight patients with EIMT confirmed by pathology and 45 patients of endobronchial nodular lesions （including 10 endobronchial tuberculosis, 5 endobronchial fibroma, 4 endobronchial laevicellulare, 15 endobronchial squamous carcinoma, 3 endobronchial adenocarcinoma and 8 endobronchial carcinoid） underwent plain and dynamic contrast-enhanced MSCT scanning, and the characteristics of EIMT were observed compared with other lesions. Results EIMT lesions located in the left lung in 3 （upper lobes in 1, and lower lobes in 2） and right lung in 5 patients （upper lobes in 1, middle lobe in 1 and lower lobes in 3）, filled one or more segments of bronchi, which were circular in 5, similar round in 2 and 1 irregular shaped. Plain CT showed uniform soft tissue density. One lesion showed moderate enhancement, while the others showed significantly enhancement with fast wash-in and slow wash-out. The maximum enhancement CT value of EIMT was significantly higher than that of endobronchial tuberculosis, endobronchial fibroma, endobronchial laevicellulare, endobronchial squamous carcinoma, endobronchial adenocarcinoma, but lower than that of intraluminal endobronchial carcinoid （all P〈0.05）. Conclusion Plain MSCT manifestations of EIMT have not characteristics. Dynamic enhanced MSCT is important for the diagnosis and differential diagnosis of EIMT.

关 键 词：肺炎性肌母细胞瘤 支气管 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]