儿童肌纤维瘤(病)影像学及临床表现  

Imaging and clinical manifestations of myofibroma/myofibromatosis in children

作　　者：庄霞梅 金科[1] 李君伟[1] 尹燕[1] 王海[1] 李晓明[1] ZHUANG Xiamei;JIN Ke;LI Junwei;YIN Yan;WANG Hai;LI Xiaoming(Department of Radiology,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院放射科,湖南长沙410007

出　　处：《中国医学影像技术》2022年第4期579-583,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察儿童肌纤维瘤(病)影像学及临床表现。方法回顾性分析16例经病理确诊肌纤维瘤(病)患儿的CT、MRI及临床资料,观察其特征性表现。结果16例均见全身不同部位单发或多发浅表肿块,其中13例单发病灶多位于头面部、四肢,3例多发病灶均位于四肢和躯干且累及骨骼;肿块可呈正常肤色、红色或淡紫色,质硬,活动度差,多不伴疼痛、发热及皮温升高。平扫CT肿块呈混杂密度,实性部分呈稍低密度,11例(11/16,68.75%)病灶伴囊变,6例(6/16,37.50%)伴钙化;增强CT扫描,病灶多呈中、重度不均匀强化,周边多明显强化。MR平扫中肿块均表现为混杂信号;增强后病灶均呈不均匀强化,且周边强化明显。3例病变累及骨骼,影像学见骨质密度减低区/稍长T1长T2信号,边界清晰,无明显骨膜反应,增强后多呈中、高度强化。结论肌纤维瘤(病)多见于2岁以下婴幼儿,多表现为头面部和四肢单发、无痛性结节,可呈正常肤色、红色或淡紫色,亦可多发并累及骨骼;CT/MRI可呈密度/信号不均的实性肿块,血供丰富,多伴囊变,增强后多呈中、高度强化,周边强化明显。Objective To observe the imaging and clinical manifestations of myofibroma/myofibromatosis in children.Methods CT,MRI and clinical data of 16 children with myofibroma/myofibromatosis diagnosed by pathology were retrospectively analyzed,and the characteristic manifestations of myofibroma/myofibromatosis were observed.Results Single or multiple superficial masses in different parts of body were detected in all 16 cases,including 13 cases with single lesion located in head,face and limbs,as well as 3 cases with multiple lesions located in limbs and trunk and involved bones.Most of the masses were hard with poor mobility,presented as normal skin color,red or lavender,without pain,fever nor elevated skin temperature.The masses were found with mixed densities,and the solid parts with slightly lower densities on plain CT images.Cystic changes were detected in 11 cases(11/16,68.75%),while calcifications were observed in 6 cases(6/16,37.50%).Most masses moderately and severely unevenly enhanced after administration of contrast agent,with obvious peripheral enhancements.On plain MRI,the masses present mixed signals,which present as uneven enhancement with obvious peripheral enhancement after administration of contrast agent.Bone involvements occurred in 3 cases,manifested as reduced bone density/slightly long T1 and long T2 signals with clear boundary but no obvious periosteal reaction,which enhanced moderately or highly.Conclusion Myofibroma/myofibromatosis tended to occur in young infants under 2 years old,mostly presented as single painless nodule with normal skin color,red or lavender,mainly located in head,face and limbs,which could be multi-lesions and involving bones.Most lesions of myofibroma/myofibromatosis present as solid mass with uneven density/signal with abundant blood supply on plain CT/MRI,accompanied by cystic changes,moderately or highly enhanced with obvious peripheral enhancement after administration of contrast agent.

关 键 词：肌纤维瘤 肌纤维瘤病 儿童 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738.7[医药卫生—肿瘤] R445[医药卫生—临床医学]