肝脏炎性肌纤维母细胞瘤的CT、MRI表现及其与病理对照分析  

CT and MRI features and pathologic findings of hepatic inflammatory myofibroblastic tumor

作　　者：陈天忠[1] 李涛[2] 龙光宇[1] 冯廷越[1] 凌翔[1] 程旭坚 韦江龙[1] 

机构地区：[1]广西科技大学第一附属医院放射科,广西柳州545002 [2]广西柳州市工人医院放射科

出　　处：《实用放射学杂志》2016年第11期1706-1709,共4页Journal of Practical Radiology

摘　　要：目的探讨肝脏炎性肌纤维母细胞瘤（HIMT）的CT及MRI表现，并与病理对照分析，以提高对该病的影像诊断水平。方法回顾性分析经手术或穿刺活检病理证实的19例HIMT患者的影像表现与病理学特点，其中19例均行CT平扫及动态增强扫描，3例同时行MR平扫及动态增强扫描。结果19例HIMT，18例单发，1例多发，共20个病灶，18个位于肝右叶，2个位于左叶，病灶直径12．8～38．6mm，平扫CT呈等密度结节或肿块，3例MR共3个病灶，T2WI均呈略高信号显示，T1WI有1例病灶呈略高信号，2个病灶呈等低信号，动态增强扫描8个病灶星整瘤不规则强化，4个病灶呈花环、葫芦边缘延时强化，3个病灶呈分隔样强化，3个病灶三期无强化，1个病灶动脉期边缘模糊强化，门脉期及延时期呈等密度显示。1个病灶内可见“血管漂浮征”。全部病灶病理镜下均可见正常肝脏组织结构破坏，不同程度凝固坏死，纤维组织增生，伴有炎症细胞浸润。结论HIMT的CT及MRI表现充分反映其病理学特点，影像学检查能为临床诊断及鉴别诊断HIMT提供有价值的信息。Objective To investigate the CT and MR imaging features of hepatic inflammatory myofibroblastic tumor （HIMT） in comparison withthe pathology,to improve the diagnostic accuracy. Methods The CT findings of 19 patients with HIMT which was confirmed by surgery or biopsy pathology were analyzed retrospectively. The plain and dynamic contrast-enhanced CT was per- formed in all cases, and MRI was examined in 3 cases. Results Of the 19 cases with 20 HIMTs, 18 had a single lesion, and 1 case had multiple ones. The lesion was located in the right lobe of liver in 18 cases and in the left lobe in 2. The lesions ranged from 12.8 mm to 38.6 mm in diameter. The tumors appeared iso-intensity nodules or masses on plain CT. 3 lesions in 3 cases with slightly high signal intensity on T2 WI, one lesion with slightly high signal intensity on T1WI, and two lesions with slightly lower signal intensity on T1WI were found. 8 lesions with irregular enhancement, 4 with garland-like or gourd-like delayed enhanced edge, 3 with uneven enhancement with separation, 3 wiohout enhancement, and 1 with blur enhanced edge in arterial phase and iso-density in portal and delayed phases were also found. One appeared ＂floating＂ blood vessels in the lesion. All lesions in pathology demonstrated destroyed liver tissue structures with different degree of coagulation necrosis, fiber tissue hyperplasia and accompanied inflammatory ceils infil- tration. Conclusion CT and MRI manifestations of HIMT, which are correlated with its pathologic findings, may provide valuable information for clinical diagnosis and differential diagnosis.

关 键 词：肝脏 炎性肌纤维母细胞瘤 计算机体层成像 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]