肺炎性肌纤维母细胞瘤MDCT表现与病理对照研究  

Comparative study of MDCT manifestations and pathology of infiammatory myofibroblastic tumour

作　　者：刘玉建[1] 仲建全[1] 冯浩[1] 张雨涛[2] 王辉[3] LIU Yujian;ZHONG Jianquan;FENG Hao;ZHANG Yutao;WANG Hui(Department of Radiology,First People's Hospital,Zigong City,Zigong 643000,P.R.China;Pathology Department,First People's Hospital,Zigong City,Zigong 643000,P.R.China;Department of Radiology,People's Hospital of Xinjiang Uygur Autonomous Region,Urumchi 830000,P.R.China)

机构地区：[1]四川省自贡市第一人民医院放射科,四川自贡643000 [2]四川省自贡市第一人民医院病理科,四川自贡643000 [3]新疆维吾尔自治区人民医院放射科,新疆乌鲁木齐830000

出　　处：《医学影像学杂志》2021年第7期1160-1162,1167,共4页Journal of Medical Imaging

摘　　要：目的探讨肺炎性肌纤维母细胞瘤(IMT)的MDCT影像特征。方法选取我院经手术或CT引导下肺穿刺活检并病理证实肺炎性肌纤维母细胞瘤患者33例,分别从临床表现及CT征象进行回顾性分析总结。结果本组33例患者共37个病灶,多发4例。男性24例;女性9例。病灶部位右肺上叶10个;右肺中叶8个;右肺下叶9个;左肺上叶3个;左肺下叶6个;主支气管1个。肿瘤最小约0.5 cm,最大约14.6 cm,平均3.6 cm。病灶密度均匀20例,不均匀13例,其中2例较大者可见液化坏死。2例见斑点状、小片状钙化,边界清楚24例,边界不清9例,周围见晕征20例。相邻支气管通畅25例,支气管堵塞4例,不能评价4例。病灶内有血管穿行28例,无血管穿行5例。与胸膜相连29例,4例未与胸膜相连。增强扫描30例,均匀强化18例,不均匀强化12例。37个病灶其中29个病灶均位于肺外周。33例患者均未发现病灶周围及胸腔内肿大淋巴结。随访患者20例,2例复发。结论肺炎性肌纤维母细胞MDCT影像表现具有一定特征性,结合其临床表现术前能够做出提示性诊断。Objective To investigate the MDCT imaging features of inflammatory myofibroblastic tumour(IMT).Methods Thirty-three patients with pulmonary inflammatory myofibroblastic tumor confirmed by surgery or CT-guided lung biopsy and pathology from January 2015 to June 2019 in our hospital were retrospectively collected.Then,retrospective analysis and summary from clinical manifestations and CT signs were conducted.Results There were 37 lesions in 33 patients in this group including 24 males and 9 females,and 4 lesions were multiple.There were 10 lesions located in the upper lobe of the right lung;There were 8 cases in the middle lobe of the right lung;There were 9 in the lower lobe of the right lung;There were 3 in the upper lobe of the left lung;There were 6 in the lower lobe of the left lung;There was one main bronchus;The minimum tumor size was about 0.5 cm,the maximum was about 14.6 cm,with an average of 3.6 cm.The density of lesions was uniform in 20 cases and uneven in 13 cases,of which liquefaction necrosis was found in 2 cases with larger lesions.Spotted and patchy calcification was found in 2 cases.24 cases had clear boundary and 9 cases had unclear boundary.Halo sign was seen in 20 cases.25 cases of adjacent bronchus were unobstructed,4 cases of bronchial obstruction,and 4 cases could not be evaluated.There were 28 cases with vascular penetration and 5 cases without vascular penetration.29 cases were connected with pleura,4 cases were not connected with pleura;Enhanced scanning was performed in 30 cases,omogeneous enhancement in 18 cases and heterogeneous enhancement in 12 cases.Of the 37 lesions,29 were located in the periphery of the lung.No enlarged lymph nodes were found around the lesion or in the thoracic cavity in 33 patients.Twenty patients were followed up and 2 relapsed.Conclusion The MDCT imaging manifestations of inflammatory myofibroblastic tumour have certain characteristics,and combined with their clinical manifestations,suggestive diagnosis can be made before operation.

关 键 词：肺间叶性肿瘤 体层摄影术 X线计算机 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]