探讨多模态影像学对脾脏炎性肌纤维母细胞瘤的诊断价值  

To Evaluate the Value of Multimodal Imaging in the Diagnosis of Splenic Inflammatory Myofibroblastoma

作　　者：王嫚 沈中原 李金民 张聪 阚宏 WANG Man;SHEN Zhong-yuan;LI Jin-min;ZHANG Cong;KAN Hong(Department of Nuclear Medicine,Fuyang Hospital Affiliated to Anhui Medical University,Fuyang 236000,Anhui Province,China;Department of Radiology,Fuyang Hospital Affiliated to Anhui Medical University,Fuyang 236000,Anhui Province,China;Department of Ultrasound,Fuyang Hospital Affiliated to Anhui Medical University,Fuyang 236000,Anhui Province,China;Department of Pathology,Fuyang Hospital Affiliated to Anhui Medical University,Fuyang 236000,Anhui Province,China)

机构地区：[1]安徽医科大学附属阜阳医院核医学科 [2]安徽医科大学附属阜阳医院放射科 [3]安徽医科大学附属阜阳医院超声科 [4]安徽医科大学附属阜阳医院病理科,安徽阜阳236000

出　　处：《中国CT和MRI杂志》2024年第11期109-111,共3页Chinese Journal of CT and MRI

基　　金：安徽省自然科学基金(1808085MH283);2024年度安徽省高校科学研究项目(2024AH050736)。

摘　　要：目的为了提高脾脏炎性肌纤维母细胞瘤的诊断水平,探讨多模态影像学的价值。方法回顾分析本院1例成人脾炎性肌纤维母细胞瘤(inflammatory pseudotumor of spleen,SIMT)患者的影像资料,包括彩色超声、CT平扫及增强、MRI平扫,并复习文献。结果脾脏内数枚肿块,以低回声为主,回声不均,边界尚清,形态规整,内见少许血流信号。CT平扫为等密度,其内见小片状低密度区;增强后呈轻度至中度不均匀强化。MRI表现:T1WI上低或等信号,T2WI序列及T2WI抑脂序列为等及高信号,病灶周围见完整包膜,DWI图为等及高信号,信号不均匀。病理学及免疫组化结果为SIMT;EB病毒(+)。结论SIMT临床表现缺乏特异性,最终需病理学确诊。多模态影像学检查对脾炎性肌纤维母细胞瘤有很高的诊断和鉴别诊断价值。Objective In order to improve the diagnostic level of inflammatory myofibroblastoma of spleen,the value of multimodal imaging was discussed.Methods The imaging data of 1 case of adult inflammatory pseudotumor of spleen(SIMT)in our hospital were retrospectively analyzed,including color ultrasound,CT plain and enhanced scan,MRI plain scan,and the literature was reviewed.Result There were several masses in the spleen,mainly low echo,uneven echo,clear boundary,regular shape,and a few blood flow signals.CT plain scan showed equal density,and small flake areas of low density were found in it.The enhancement showed mild to moderate uneven enhancement.MRI findings:low or equal signal on T1WI,slightly high signal on T2WI and T2WI lipid suppression sequences,high signal on DWI,even signal,no complete capsule around the lesion.The pathological and immunohistochemical results were SIMT.Epstein Barr virus(+).MRI findings:low or isosignal on T1WI,isohigh signal on T2WI and T2WI liposuppressive sequences,complete capsule around the lesion,isohigh signal on DWI,uneven signal.The pathological and immunohistochemical results were SIMT.In situ hybridization:Epstein-Barr virus(+).Conclusion The clinical manifestations of SIMT are lack of specificity and ultimately need to be confirmed by pathology.Multimodal imaging is valuable in the diagnosis and differential diagnosis of splenic inflammatory myofibroblastoma.

关 键 词：超声检查 体层摄影术 X线计算机 磁共振成像 脾脏 炎性肌纤维母细胞瘤 

分 类 号：R445.3[医药卫生—影像医学与核医学] R445.2[医药卫生—诊断学]