少见腹盆腔炎性肌纤维母细胞瘤CT表现并与病理对照分析  

Comparative analysis of CT findings and pathology of inflammatory myofibrohlastic tumor in the rare abdominal and pelvic

作　　者：程冰雪 周莉[1] 杨晨 CHENG Bingxue;ZHOU Li;YANG Chen(Department of Radiology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院影像科,江西南昌330006

出　　处：《实用放射学杂志》2019年第10期1610-1613,共4页Journal of Practical Radiology

摘　　要：目的探讨少见腹盆腔炎性肌纤维母细胞瘤(IMT)CT表现,并与病理对照,以提高对该病的诊断准确率和认识。方法回顾性分析17例少见腹盆腔IMT患者影像、临床及病理资料,11例行腹部CT平扫及增强扫描,3例行腹部CT平扫扫描,3例行腹部CT增强扫描。结果 17例腹盆腔IMT中男8例,女9例;单发15例,多发2例;位于胃、结肠、膀胱各4例,脾3例,肾、脐尿管各1例。17例腹盆腔IMT中2例结肠IMT病灶位于肠腔内,未做小肠低张,肠道充盈差,并且病灶呈软组织密度,与邻近肠内容物难区分,CT平扫漏诊,余15例均呈软组织密度,9例边界清,6例边界不清;4例病灶周围脂肪间隙模糊,呈感染渗出表现,5例病灶周围伴有肿大淋巴结;10例密度不均匀,1例膀胱IMT病灶边缘线状钙化,1例胃窦IMT病灶中央见团块状骨化,9例病灶内见明显坏死、囊变区;5例密度均匀。增强扫描呈轻度、中度或明显强化,强化方式多种多样,表现为均匀或不均匀延时强化。10例动脉期病灶内见血管影。17例病灶均为原发,术后随访均未复发。结论原发于腹盆腔的IMT的特征包括:病灶周围呈感染渗出表现,病灶表现为均匀或不均匀延时强化,以及动脉期病灶内见血管影,病灶边缘及中央偶尔可见钙化,病灶内出现骨化非常少见。Objective To explore the CT finding of inflammatory myofibroblastic tumor (IMT) in the rare abdominal or pelvic, and compare their pathologies,to improve the accuracy of diagnosis and understanding of the disease.Methods The imaging,clinical and pathological data of 17 cases with IMT in the rare abdominal or pelvic were analyzed retrospectively.il cases were performed with plain and enhanced scan, 3 cases had plain scan only,and 3 cases had enhanced scan only.Results Among the 17 cases,8 cases were male,9 cases were female;15 cases were single,2 cases were multiple;4 cases were located in the stomach,colon or bladder,3 cases located in spleen, 1 case located in kidney or urachus.Among those,2 lesions located in the colon cavity presented as soft tissue, it was difficult to distinguish the lesion from the adjacent intestinal contents since the small intestinal hypotonic CT examination was not performed and the intestinal filling was poor,thus those lesions were missed diagnosed with CT plain scan.Thc remaining 15 cases presented as soft tissue density as well,among those,9 cases presented with clear border while 6 cases with blurred border;the peripheral fat space of 4 cases were blurred and presented as infection and exudation,5 cases were accompanied with lymph node enlargement around the lesion;the density of 10 cases were uneven,among those, 1IMT lesion in bladder presented with linear calcification, 1IMT lesion in gastric antrum presented with nodular ossification in the center,9 cases showed obvious necrosis and cystic degeneration;5 cases showed even.After contrast administration,the lesions were enhanced mildly, moderately or significantly. The enhancement type were various, presented as uniform or nonuniform delayed enhancement.Vessel shadow was observed in 10 cases during arterial phase.All of the 17 lesions were primary, and no recurrence was found during follow-up.Conclusion The feature of IMT in the abdominal or pelivic including the following: the peripheral area of the lesion presenting as infection

关 键 词：炎性肌纤维母细胞瘤 腹盆腔 计算机体层成像 病理 

分 类 号：R730.262[医药卫生—肿瘤] R739.9[医药卫生—临床医学]