儿童骨内肌纤维瘤/肌纤维瘤病的CT和MRI表现  

CT and MRI features of intraosseous myofibroma/myofibromatosis in children

作　　者：杨利新[1] 姚兴凤[2] 唐晓璐[1] 吴荣昌[1] 彭芸[1] YANG Lixin;YAO Xingfeng;TANG Xiaolu;WU Rongchang;PENG Yun(Imaging Center;Department of Pathology,Beijing Children’s Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院影像中心,北京100045 [2]首都医科大学附属北京儿童医院病理科,北京100045

出　　处：《实用放射学杂志》2024年第8期1334-1337,共4页Journal of Practical Radiology

基　　金：北京市医院管理中心“登峰”计划专项(DFL20221002)。

摘　　要：目的探讨儿童骨内肌纤维瘤/肌纤维瘤病的CT及MRI表现。方法回顾性分析15例经病理证实的侵犯骨的肌纤维瘤/肌纤维瘤病患儿的临床资料及影像学表现,总结其影像特点。结果15例患儿均行CT检查,其中2例同时行增强扫描,并有5例行MRI检查,其中3例同时行增强扫描。其中11例诊断为孤立型,发生在颅骨7例,其余均发生在颌面骨。3例为多中心型无内脏受累,1例为多中心型合并内脏受累。CT平扫病灶呈均匀软组织密度影,多发生在骨的内外板之间,呈膨胀性改变并溶骨性骨质破坏,部分病灶内保留残留的骨壳。MRI上病灶信号较为均匀,T1WI呈等或稍低信号,T2WI呈等或稍高信号。CT及MRI增强示病灶明显不均匀强化。结论儿童骨内肌纤维瘤/肌纤维瘤病影像表现有一定特征性,病灶内残留的骨壳对诊断有一定的提示作用,但与骨朗格汉斯细胞组织细胞增多症的鉴别仍具有挑战性,需要依靠病理诊断。Objective To investigate the CT and MRI features of intraosseous myofibroma/myofibromatosis in pediatric patients.Methods The retrospective analysis involved the examination of clinical data and imaging findings from 15 children who were diagnosed with myofibroma/myofibromatosis of bone invasion through pathological means.Subsequently,the imaging characteristics were summarized.Results CT examinations were conducted on a total of 15 patients,with 2 of them also received enhanced scans.Additionally,MRI examinations were conducted on 5 patients,with 3 of them also underwent enhanced scans.Eleven patients were diagnosed with solitary type myofibroma,with 7 cases localized in the skull and the remaining lesions observed in the maxillofacial bone.Three patients exhibited the multicentric type without any involvement of visceral organs,while one patient presented with the multicentric type accompanied by visceral involvement.The lesions exhibited a uniform soft-tissue density on plain CT scan,predominantly located between the inner and outer layers of the bone.Additionally,they displayed swelling changes and osteolytic bone destruction,with some lesions showed residual bone shell.On MRI,the lesions exhibited a uniform signal,demonstrated an isointense or slightly hypointense signal on T1WI and an isointense or slightly hyperintense signal on T2WI.The lesions displayed significantly heterogeneous enhancement on CT and MRI.Conclusion The imaging manifestations of intraosseous myofibroma/myofibromatosis in pediatric patients exhibit certain characteristics,and the residual bone shell in the lesion is helpful for diagnosis,however,distinguishing it from Langerhans cell histiocytosis of the bone remains challenging,necessitating the reliance on pathological diagnosis.

关 键 词：儿童 肌纤维瘤/肌纤维瘤病 骨 计算机体层成像 磁共振成像 

分 类 号：R339.31[医药卫生—人体生理学] R738.6[医药卫生—基础医学] R814.42R445.2