肩背部弹力纤维瘤的CT及MRI诊断价值  

Value of CT and MRI in diagnosis of elasticfibrous dorsi

作　　者：陈香卫[1] 于建秀[1] 李鑫欣[1] 林明强[1] 田军[2] 

机构地区：[1]山东省文登整骨医院CT、MRI室,山东威海264400 [2]山东大学附属山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2017年第6期1156-1158,1163,共4页Journal of Medical Imaging

摘　　要：目的探讨多层螺旋CT和MRI检查在肩背部弹力纤维瘤诊断中的价值。方法回顾性分析2012年2月~2015年6月经手术病理证实的9例弹力纤维瘤患者,所有患者均行CT检查,其中4例行MRI检查。分析肩背部的弹力纤维瘤的临床特点及影像学表现。结果 9例患者,年龄41~74岁,8例为女性,1例为男性,2例位于右侧,2例位于左侧,5例为双侧性,除了临床表现为双侧性4例外,还有1例为临床表现单侧病变而胸部CT扫描发现对侧有较小的亚临床阶段病灶。14个病灶均位于背部肩胛下角区肌肉深面与胸壁间的脂肪间隙内,呈扁丘状,边缘清楚或模糊。肿块于CT上呈等密度或稍低密度,其内可见条纹状极低脂肪密度影;肿块于MR上信号不均,T1WI呈中等信号为主的肌纤维组织与高信号脂肪组织交替排列,脂肪抑制T2WI高信号脂肪信号被抑制。结论中老年女性,单侧或双侧肩胛下角区无痛性肿块与CT或MRI影像学表现,可以在术前较准确的诊断为肩背部弹力纤维瘤,且CT和MRI检查有利于发现亚临床阶段的病变。Objective To assess the value of MSCT and MRI in the diagnosis of elasticfibrous dorsi. Methods Nine patients with elasticfibrous dorsi confirmed by surgery and pathology were enrolled from February 2012 to June 2015 into this study. All patients underwent plain chest CT,while 4 underwent plain chest MRI. Clinical features and imaging characteristics of EFD were analyzed. Results 9 patients were aged between 41 and 74 years old,and 8 were female and 1 was male. There were 2 patients on the right and 2 patients on the left,while 5 patients had bilateral lesions. In addition to the clinical manifestations of bilateral4 patients,there was 1 patient whose clinical manifestations were unilateral lesions while smaller subclinical stage lesions were found on the opposite side by chest CT. All 14 lesions located in the deep subscapular muscle at the scapular angle area in the back and the fat space between the chest wall. They were flat in shape,clear or fuzzy on boundary. Masses performance appeared as isodense or slightly low density in CT,and fat density was seen of masses,presenting as spaced stripe. Masses had inhomogeneous signal intensity on MRI with intermingled muscle and fat intensities on T1 WI,and fat signal was suppressed as fat suppressed T2 WI high signal. Conclusion Middle-aged women should be definitely diagnosed elasticfibrous dorsi with painless masses in the area of unilateral or bilateral lower side of the shoulder and the performance of CT or MRI before surgeries. Bilateral simultaneous examination is beneficial for the discovery of subclinical lesions.

关 键 词：弹力纤维瘤 影像学诊断 肩 

分 类 号：R445[医药卫生—影像医学与核医学] R738.3[医药卫生—诊断学]