结节性筋膜炎的临床及影像学表现  

Clinical and imaging features of nodular fasciitis

作　　者：徐贵平[1] 强永乾[1] 曹培龙[2] XU Gui ping;QIANG Yongqian;CAO Peilong(Department of Medical Imaging,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Pathology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]西安交通大学第一附属医院病理科,陕西西安710061

出　　处：《实用放射学杂志》2020年第1期91-94,共4页Journal of Practical Radiology

摘　　要：目的分析结节性筋膜炎(NF)的临床特点和影像学表现.方法回顾性分析经手术病理证实的97例NF患者的临床、MRI及超声检查资料,其中男46例,女51例,年龄4~77岁,平均(39.3±16.6)岁.其中5例行MRI检查,15例行超声检查.结果97例NF有98个结节,皮下型占91.8%(90/98),筋膜型占8.2%(8/98),最大径0.4~3.5 cm,平均(1.5±0.8)cm.位于上肢占38.8%(38/98),躯干部占23.5%(23/98),头颈部占21.4%(21/98),下肢占16.3%(16/98).病程10 d^4个月,3例病灶在MRI上呈卵圆形结节,2例有浅分叶,长轴均与肌肉或深筋膜长轴方向一致.T1 WI呈均匀等信号,T2 WI呈均匀或不均匀高信号,4例可见假包膜、筋膜尾征及灶周水肿.在超声上,11例病灶表现为椭圆形或梭形结节,4例有浅分叶,10例呈较均匀的低回声,5例病灶内可见稍强回声.13例边界清晰,1例伴有蟹足征,1例见筋膜尾征,15例中有2例彩色多普勒血流成像(CDFI)可见血流信号.结论NF具有相对特异的临床表现,影像学对NF诊断具有较高诊断价值,结节周围水肿、筋膜尾征和假包膜有助于诊断.Objective To analyze the clinical and imaging features of nodular fascitis(NF).Methods The clinical,MRI and ultrasonography data of 97 patients with NF confirmed by postoperative pathology were analyzed retrospectively.There were 46 males and 51 females,aged from 4 to 77 years,with an average age of(39.3±16.6)years.Among them,5 cases underwent MRI and 15 cases underwent ultrasonography.Results There were 98 NF nodules in 97 cases.The subcutaneous type and fascial type accounted for 91.8%(90/98)and.8.2%(8/98)respectively.The maximum diameter was 0.4-3.5 cm,with an average of(1.5±0.8)cm.38.8%(38/98)were located in the upper limbs,23.5%(23/98)in the trunk,21.4%(21/98)in the head and neck,and 16.3%(16/98)in the lower limbs.On MRI,the lesions were oval nodules in 3 cases and supericial lobulation in 2 cases.The long axes of the lesions were consistent with those of muscles or deep fascia.They showed iso intensity on T,WI and hyper intensity on T:WI.Pseudo capsule,fascial tail sign and perifocal edema were seen in 4 cases.On ultrasonography,11 cases showed as elliptical or spindle nodules and 4 cases were slightly lobulated,10 cases were relatively homogenous hypochoie and 5 cases had hyper echocs inside.13 cases had clear boundary,1 case had crab-feet sign and another 1 case had fascial tail sign.Blood flow signals were visible on CDFI in 2 of 15 cases.Conclusion NF has relatively specific clinical manifestations,imaging is of high diagnostic value.Some special appearances,such as subcutaneous nodule with edema,fascia tail sign,and pseudo capsule are helpful for diagnosis.

关 键 词：结节性筋膜炎 磁共振成像 超声 

分 类 号：R686.3[医药卫生—骨科学] R445.2[医药卫生—外科学]