儿童眼眶横纹肌肉瘤临床及影像:5例分析  

Clinical and imaging features of orbital rhabdomyosarcoma in children:analysis of 5 cases of misdiagnosis

作　　者：浦俭 何茜[1] 向述天[1] 毛崇文[1] 刘晨[1] 苏云杉[1] PU Jian;HE Qian;XIANG Shutian;MAO Chongwen;LIU Chen;SU Yunshan(Department of Radiology,Fourth Affiliated Hospital of Kunming Medical University,Kunming 650021,China)

机构地区：[1]昆明医科大学第四附属医院放射科,昆明650021

出　　处：《国际医学放射学杂志》2020年第3期343-347,共5页International Journal of Medical Radiology

摘　　要：目的探讨儿童眼眶横纹肌肉瘤(RMS)的临床及CT、MRI影像特征。方法收集5例经手术病理证实的儿童眼眶RMS的临床、病理及CT、MRI影像资料,并结合文献进行分析。结果5例儿童眼眶RMS均位于眼眶内,左侧3例,右侧2例。5例中3例为实性病灶,与眼直肌相比,CT平扫呈稍高密度,增强后明显均匀强化;MRI平扫T1WI呈稍低信号、T2WI呈稍高信号,DWI呈高信号,增强后明显均匀强化,动态增强MRI时间-信号强度曲线呈"流入"型。另2例为囊实性病灶,以实性成分为主,中心小片状囊变,实性部分密度/信号及强化方式与实性病灶一致,中心囊性部分CT平扫呈低密度,MRI平扫T1WI呈低信号、T2WI呈高信号,DWI呈等信号,增强扫描无强化。病理诊断为胚胎性RMS。结论儿童眼眶RMS的临床及影像表现具有一定特征性,但临床上少见、术前诊断困难,充分认识其影像特征并结合临床表现有助于临床诊断和术前评估。Objective To investigate the clinical,CT and MRI features of orbital rhabdomyosarcoma(RMS)in children.Methods The clinicopathological,CT and MRI data of 5 cases of orbital RMS confirmed by operation and pathology were analyzed,and related literatures were reviewed.Results All the orbital RMSs situated within the orbit fossa,3 in the left and 2 in the right side.Solid lesions were identified in 3 of 5 cases.The lesions showed slightly hyperdensity compared to rectus oculi on plain CT scan,and were heterogeneously enhanced.The solid lesions showed slightly low signal on T1WI,slightly high signal on T2WI,and high signal on DWI.After contrast medium was administrated,the solid lesions were heterogeneously enhanced,and the time signal intensity curve showed“inflow”type.The remain 2 cases were cystsolid mixed lesions,mainly composed of solid components with central small cystic change.In the solid component,the density/signal and enhancement behaviors were consistent with the solid lesions.The central cystic component was hypodensity on plain CT scan,and low signal on T1WI,high signal on T2WI,equal signal on DWI,and no enhancement after administration of contrast medium.The pathological diagnosis of each cases was embryonal rhabdomyosarcoma.Conclusion The RMS in children is rare and it’s difficult to make accurate diagnosis before operation.However,the clinical and imaging features are characteristic.By combining its clinical and imaging features,it is helpful to evaluate the tumor and establish preoperative diagnosis.

关 键 词：眼眶 横纹肌肉瘤 儿童 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.7+2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]