CT和MRI诊断背部弹力纤维瘤的临床价值  

Clinical value of CT and MRI in the diagnosis of elastofibroma dorsi

作　　者：徐春华[1] 李玉彬[2] 李宁 XU Chun-hua;LI Yu-bin;LI Ning(Department of Radiology,Guang'anmen Hospital,Chinese Academy of Chinese Medical Sciences,Beijing 100053,China;Department of Orthopedics,Guang'anmen Hospital,Chinese Academy of Chinese Medical Sciences,Beijing 100053,China;Department of Radiology,Cancer Hospital Affiliated to University of Chinese Academy of Sciences,Hangzhou Jiangsu 310022,China)

机构地区：[1]中国中医科学院广安门医院放射科,北京100053 [2]中国中医科学院广安门医院骨科,北京100053 [3]中国科学院大学附属肿瘤医院放射科,江苏杭州310022

出　　处：《临床和实验医学杂志》2020年第16期1783-1785,共3页Journal of Clinical and Experimental Medicine

基　　金：北京市科学技术委员会科技计划项目(编号:Z161100001816017)。

摘　　要：目的探讨CT和MRI诊断背部弹力纤维瘤的临床价值。方法采用回顾性方法,选取2017年10月至2019年10月中国中医科学院广安门医院放射科收治的背部弹力纤维瘤患者40例,接受CT和MRI检查,分析CT和MRI检查及病理结果。结果40例患者中,CT检查发现病变66处,在病灶位置方面,双侧26例,右侧8例,左侧6例,双侧发病率为65.0%。CT增强扫描16例患者32个病灶中,10例患者20个病灶未强化,6例患者12个病灶轻度强化。背部弹力纤维瘤病灶平扫/增强CT值均显著低于前锯肌(P<0.05),均显著高于周围脂肪(P<0.05)。MRI平扫检查8例患者12个病灶,同时增强检查2例,在病灶位置方面,双侧4例,右侧2例,左侧2例,主要表现均为骨骼肌信号,有呈间隔状排列的条状长T2信号,脂肪高信号被脂肪抑制成像T1WI、T2WI抑制为低信号。术中见肿块无包膜,有脂肪组织覆盖在其表面,在肩胛下区背阔肌、菱形肌、前锯肌深部分布,基底在胸肋侧分布,与周围肌肉组织缺乏清晰的分界,与肋骨、肋间肌邻近。切面具有柔韧的质地,灶状颗粒相间,呈淡黄色和灰白色。镜下见脂肪组织灶状分布,有大量束状胶原纤维、粗大弹力纤维,苏木精-伊红染色弹力纤维呈粉红色。结论背部弹力纤维瘤病灶的平扫CT值和增强CT值均明显低于前锯肌,而高于周围脂肪;MRI脂肪抑制成像T1WI、T2WI抑制脂肪高信号为低信号。CT和MRI对该病均有较高的诊断价值。Objective To explore the clinical value of CT and MRI in the diagnosis of elastofibroma dorsi.Methods 40 cases of patients with elastofibroma dorsi in Department of Radiology,Guang'anmen Hospital,Chinese Academy of traditional Chinese Medicine from October 2017 to October 2019 were retrospectively selected,all of them were examined by CT and MRI,and the CT and MRI examination and pathological results were analyzed.Results 66 lesions of the 40 cases were found on CT.In terms of lesion location,26 cases were bilateral,8 cases were on the right side,and 6 cases were on the left side.The incidence of bilateral lesions was 65.0%.CT-enhanced scans were performed in 16 patients with 32 lesions,12 lesions in 6 patients were with mild enhancement and 20 lesions in 10 patients were without enhancement.The plain/enhanced CT values of the elastofibroma dorsi were both significantly lower than those of the anterior serratus(P<0.05)and significantly higher than those of the surrounding fat(P<0.05).12 lesions in 8 patients were examined by MRI,with enhancement in 2 cases.In terms of lesion location,4 cases were bilateral,2 cases were on the right side,and 2 cases were on the left side.The main manifestations were skeletal muscle signals,with strip like long T2 signals arranged in an interval like manner,and fat high signal was suppressed by fat suppression imaging on T1WI and T2WI.Intraoperatively,the mass was seen to be unencapsulated,with fatty tissue covering its surface and distributed in the subscapular region of the deep latissimus dorsi,rhomboids,and anterior serratus.The base was distributed on the side of the chest ribs,adjacent to the ribs and intercostal muscles and lack of clear demarcation from the surrounding muscles.The cut had a pliable texture with intervals of focal particles,which were pale yellow and grayish white in color.Under the microscope,the focal distribution of fat tissue was seen,with a large number of bundles of collagen fibers and coarse elastic fibers which was pink after hematoxylin-eosin staine

关 键 词：背部弹力纤维瘤 CT MRI 

分 类 号：R738.6[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2