眼眶炎性假瘤眶外蔓延的MRI表现

目的探讨眼眶炎性假瘤眶外蔓延的途径、MRI表现与临床特点。资料与方法回顾分析我院2005年11月至2010年12月收治的13例经手术或临床证实的炎性假瘤眶外蔓延的病例,结合文献总结其临床特点与MRI表现结果13例患者中慢性病程9例,急性或亚急性病程4例。5例手术证实,其中3例为混合型炎性假瘤,2例为硬化型炎性假瘤。8例临床证实,经激素冲击治疗,症状明显缓解。MRI表现为经眶上裂蔓延13例,经眶下裂蔓延10例,经视神经管蔓延1例,经眶下孔蔓延3例。眶外蔓延者临床表现与无眶外蔓延者比较无特异性。结论炎性假瘤眶外蔓延主要经眶上裂、眶下裂蔓延,常在影像检查中被发现。MRI能清楚显示眶外蔓延的途径及范围。     

肺炎性假瘤的影像学诊断

本文回顾性分析４２例经手术病理证实的肺炎性假瘤Ｘ线平片、体层摄影及ＣＴ扫描的影像学表现。认为年龄、性别及病灶的倍增时间对本病的鉴别意义不大，而密切结合临床、全面掌握假瘤的影像学征象特点，尤其是病灶局部胸膜增厚、粘连及“桃尖征”、肿块周围长毛刺等征象对肺炎性假瘤诊断意义重大。文中对引起术前误诊的原因进行了探讨，并对影像学检查的诊断价值进行了评价。     

MRI诊断肝脏炎性假瘤

目的 :探讨MRI对肝脏炎性假瘤 (IPL)的诊断价值。材料和方法 :回顾性分析经病理证实的 16例IPL的MRI表现 ,并与病理所见对照。结果 :病理诊断前 13例诊断为良性病变 ,3例误诊为恶性肿瘤。T1WI低信号、T2WI高信号组 12例 :血管炎型 5例、浆细胞肉芽肿型 3例、坏死型 4例 ;T1WI和T2WI低信号组 2例 :坏死型和硬化型各 1例 ;T1WI和T2WI等信号、高信号各 1例均为血管炎型。 2例血管炎型于动脉期显著强化、门脉期和延迟期中度强化 ;3例血管炎型和 2例浆细胞肉芽肿型于动脉期轻度强化、门脉期和延迟期中度强化 ;3例坏死型于门脉期和延迟期周边轻度强化。结论 :IPL的MRI表现缺乏特异性。MRI能将多数IPL诊断为良性病变。     

肝脏炎性假瘤影像学诊断

肝脏炎性假瘤是一种少见病,易误诊为肝癌。本文讨论23例肝炎性假瘤的影像表现。全部病例均经US及CT检查,7例SPECT,5例MR及3例HAG。US检查病灶呈强回声、等回声及“牛眼”征各1例,余为低回声结节;常规CT上呈低密度区,增强后无或轻度强化;SPECT胶体显像示放射性缺损区、血池延迟显像无过度充填。MRI征象为T_1wI上呈略低信号区、PDWI呈略高或等信号、T_2WI上随回波增加信号强度减弱。HAG上肝动脉走行、分布正常、无明显肿瘤染色。患者一般情况较好,AFP阴性,无肝硬变,MRI不符合典型HCC表现,SPECT排除了HHE,HAG显示正常时,要想到本病。最终诊断仍需病理确定。     

脾脏炎性假瘤CT和MRI表现与病理对照分析

目的:探讨脾脏炎性假瘤的CT、MRI表现,提高CT、MRI对该病的认识和诊断水平。方法:回顾性分析经临床手术病理证实的6例患者的临床、CT、MRI资料,6例均行CT、MRI平扫及增强扫描,分析其CT、MRI表现特征并与病理结果对照。结果:脾脏炎性假瘤的MRI表现:T1WI序列表现为低或等信号,T2WI序列为低信号,信号特点与纤维组织增生、灶性出血、凝固性坏死、含铁血黄素沉着等有关。CT表现:CT平扫表现为等密度或稍低密度、边界清晰的肿块,其内可见散在点状高密度出血灶、小片状低密度坏死区。CT、MRI动态增强后各期强化不明显。CT、MRI可见病灶周围有不完整包膜。本组炎性假瘤病理以大量纤维组织增生为特征,间以淋巴细胞、浆细胞、组织细胞以及单核细胞等慢性炎性细胞浸润,伴以灶性出血、凝固性坏死、含铁血黄素沉着等。本组脾脏炎性假瘤CD68(巨噬或单核细胞标记物)均为阳性。结论:脾脏炎性假瘤具有特征性CT、MRI表现,CT、MRI对脾脏炎性假瘤的诊断及鉴别诊断具有重要价值。     

Inflammatory Pseudotumor in the Mediastinum: Imaging with 18F-Fluorodeoxyglucose PET/CT

Mediastinal inflammatory pseudotumor is a rare benign disease with its capability for local invasion and rapid growth. We present a case of middle-mediastinal inflammatory pseudotumor and report its contrast-enhanced chest computed tomography, ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography and pathologic findings.     

Radiologic Findings of Renal Inflammatory Pseudotumor: A Case Report

Renal inflammatory pseudotumor is a very rare benign condition of unknown etiology characterized by proliferative myofibroblasts, fibroblasts, histiocytes, and plasma cells. In the case we report, the lesion appeared on contrast-enhanced power Doppler US images as a well-defined hypoechoic mass with intratumoral vascularity, and on CT as a low-attenuated mass. Differentiation from malignant renal neoplasms was not possible.     

肺部炎性假瘤32例CT征象分析

目的:通过对32例肺部炎性假瘤患者CT征象回顾性分析,着重探讨其特征性改变及鉴别诊断意义。方法:收集并分析1993～2005年期间32例炎性假瘤患者的临床资料及胸部CT扫描。结果:根据病灶特点,可分为圆形/类圆形(23/32)和不规则形(9/32)两种基本类型;病灶显示多种CT形态学表现,包括浅分叶征、“桃尖征”、“平直征”和钙化等。结论:肺部炎性假瘤具有多种CT表现,致其难以与其他肺部疾患(尤其是支气管肺癌)鉴别。但仍然存在部分征象,具有一定特异性。     

A Case Report of Inflammatory Pseudotumor Involving the Clivus: CT and MR Findings

The authors describe a rare case of inflammatory pseudotumor involving the clivus, where a soft tissue mass lesion, with extension into the prevertebral retropharyngeal space and the cavernous sinuses, was detected by CT and MRI. The mass resembled a malignant tumor or aggressive infectious lesion, and the final diagnosis of inflammatory pseudotumor was a diagnosis of exclusion, decided after histopathological examination.     

肝脏炎性假瘤的CT诊断与病理分析

目的：探讨肝脏炎性假瘤的CT表现与病理及病程的关系。方法：回顾性分析11例经病理证实的肝脏炎性假瘤患者的CT影像特征和病理表现,结合文献资料探讨病变影像、病理及病变进程之间的关系。结果：11例患者12个病灶,全部平扫表现为低密度,增强扫描4例在动脉期及门静脉期均无明显强化,有7例强化,其中2例病灶周围环状强化,病灶本身不强化,5例病灶周边不规则强化或内部间隔强化。本组CT检查有4例误诊。全部病变病检见肝脏正常组织结构破坏,代之以纤维母细胞,伴有慢性炎性细胞浸润。部分病灶中央呈片状凝固性坏死,周边组织充血水肿。结论：肝脏炎性假瘤多表现为包膜下方低密度病灶,部分病灶可强化;增强表现与不同的病理基础相关,并且反映了病变的进展过程。     

MRI动态增强扫描在肝脏炎性假瘤诊断与鉴别中的价值

目的探讨MRI平扫及动态增强在肝脏炎性假瘤(IPL)诊断与鉴别中的价值。资料与方法回顾性分析行Gd-DTPA动态增强MRI检查并经手术病理证实的IPL12例13个病灶,重点观察病灶在动态增强扫描中的强化方式及特点。结果12例患者共发现13个病灶,在T1WI上,4个病灶呈等信号,其余呈低信号。在T2WI上,6个病灶呈高信号,4个呈等信号,3个呈低信号。动态增强扫描后,病灶强化方式及特点如下:(1)全部病灶呈延迟强化;(2)动脉期4个病灶可见强化,其余无明显强化;(3)门静脉期和延迟期可见周边部环形强化(9/13,69.23%)、分隔样强化(6/13,46.15%)、中心或偏心性小结节状强化(2/13,15.38%)、全瘤不均质强化(1/13,7.69%);(4)延迟期病灶内存在无强化区(7/13,53.85%);(5)延迟期病灶缩小感(4/13,30.77%)。结论MRI动态增强扫描可反映IPL的血供特点及病理特征,对定性诊断与鉴别有较高的临床价值。     

ROS1-positive Inflammatory Myofibroblastic Tumor of the Small Bowel Causing Obstruction: A Case Report

Inflammatory Myofibroblastic Tumors (IMTs) are rare fibroblastic/myofibroblastic neoplasms that affect predominately pediatric patients and young adults. Almost half of the patients with IMTs have a chromosomal abnormality in the Anaplastic Lymphoma Kinase 1 gene on chromosome 2p23. Although these tumors occur primarily in the lung, lesions have been reported in a variety of intra-abdominal organs like the liver, spleen, and mesentery. Small bowel IMTs are particularly rare. IMTs generally pursue a benign clinical course, however intra-abdominal and retroperitoneal tumors have typically shown higher local recurrence and even distant metastases. The most common presenting symptoms of an intra-abdominal IMT are abdominal pain and change in bowel habits. Laboratory results are nonspecific and can include anemia and minor elevation of inflammatory markers like C-reactive protein. We report an unusual case of IMT in the small bowel causing the obstruction.     

Inflammatory Pseudotumor of the Mesentery

Teaching point: An inflammatory pseudotumor can occur almost everywhere in the body and has nonspecific imaging findings.     

Invasive Micropapillary Carcinoma of the Breast: MR Imaging Findings

Objective

To analyze the magnetic resonance (MR) imaging findings of invasive micropapillary carcinoma of the breast.

Materials and Methods

MR images were retrospectively evaluated in 14 patients (age range: 37-67, mean age: 49 years) with pathologically confirmed invasive micropapillary carcinoma of the breast. The enhancement type (mass/non-mass), shape, margin, contrast enhancement, and time-intensity curve pattern on the dynamic study were correlated with the histopathologic features. Associated findings, such as edema, nipple change, skin change and enlarged axillary lymph nodes were also studied.

Results

The most common features of the masses were irregular shape (12 of 14 patients, 85.8%) and irregular or spiculated margin (11 of 14 patients, 78.7%). The contrast enhancement was heterogeneous in 11 patients (78.7%), rim enhancement in 2 cases (14.2%), and homogeneous in one patient (7.1%). The predominant kinetic pattern was rapid increase (14 of 14, 100%) in the initial phase and washout (11 of 14, 78.7%) in the delayed phase. Associated non-mass like enhancement was shown in 4 patients, representing ductal carcinoma in situ. MR imaging helped detect additional sites of cancer other than the index lesion in 3 patients (21.4%). Enlarged axillary lymphadenopathy was identified in 7 of the 14 patients (50%).

Conclusion

Invasive micropapillary carcinoma appears as a mass with an irregular shape, irregular or spiculated margin and heterogeneous enhancement on MR imaging. Though these findings are not specific and are also observed with other breast malignancies, invasive micropapillary carcinoma frequently showed multiple lesions, accompanying non-mass enhancement and axillary lymph node enlargement.     

肺炎性假瘤的CT诊断

目的　探寻肺炎性假瘤的CT征象特点 ,以便与肺癌、肺结核瘤以及球形肺炎等球形病灶相鉴别。方法　搜集 31例经手术病理证实的肺炎性假瘤的CT资料进行回顾性分析。结果　肺炎性假瘤的主要CT表现 :(1 )类圆形 ,大都边缘光整的肿块 ,多为单发 ,直径在 3 .0cm左右 ,密度均匀。 (2 )局限性胸膜肥厚粘连 ,无胸水及钙化征象 ,肿块与增厚的胸壁之间有条状低密度影。 (3)病变中间层面一侧边缘垂直于胸膜呈刀切样改变。 (4)病灶边缘粗短毛刺。结论　CT检查对肺炎性假瘤的正确诊断与鉴别诊断是很有帮助的。     

肾脏炎性假瘤1例报告

肾脏炎性假瘤较少见 ,我院 1例经手术病理证实 ,现报告如下。患者　男 ,2 3岁。因左腰部疼痛 ,伴进行性加重 1个月 ,于1995 - 0 1- 10入院。患者 1月前无任何诱因感左腰部疼痛 ,呈持续性隐痛 ,不伴有畏寒、发热、尿痛、尿频、尿急。体检 :双肾区无隆起 ,无包块 ,双肾未扪及 ,左肾区有叩击痛 ,输尿管走行区无压痛 ,膀胱区无包块 ,外生殖器检查无异常。实验室检查 :尿常规阴性。肾功正常。血红蛋白 92ｇ/Ｌ ,血白细胞 6 .5×10 9/Ｌ ,中性 0 .82 ,淋巴 0 .18,血沉 10 5。Ｂ超 :左肾下极皮质内有一约 4ｃｍ× 5ｃｍ低密度区 ,回声欠均匀。ＣＴ…     

Inflammatory pseudotumor of the liver in a patient with rectal cancer: a case report

An inflammatory pseudotumor of the liver was discovered during a metastatic examination of a patient with rectal adenocarcinoma. Magnetic resonance imaging showed a three-component lesion that infiltrated a large portal vein, and CT arteriography and CT during arterial portography showed a portal obstruction. A histopathological examination proved that necrosis was present in the central zone; infiltration by proliferating connective tissue with chronic inflammatory cells was prominent in the middle zone; and fibrous changes, including pseudo-bile duct proliferation, were present in the peripheral zone. Magnetic resonance imaging revealed both portal infiltration and histopathological features including the above-noted three components. Magnetic resonance imaging is perhaps the most useful diagnostic modality.     

肺炎性假瘤的CT表现（附12例分析）

肺炎性假瘤 (Ｉｎｆｌａｍｍａｔｏｒｙｐｓｅｕｄｏｔｕｍｏｒｓｏｆｔｈｅｌｕｎｇ)是由肺内各种非特异性慢性炎症延续而来的肿瘤样炎性增生病变。临床与影像学表现缺乏特异性 ,常易误为肿瘤。本文收集 1991～1997年期间 ,资料完整的 12例肺炎性假瘤进行ＣＴ表现特点分析 ,以提高对本病的认识。1　材料与方法　　本组 12例 (其中浙江大学医学院附属一院 11例 ,浙江省永嘉县人民医院 1例 ) ,男性 5例 ,女性 7例。年龄 17～ 6 1岁 ,平均年龄 47.8岁。临床表现有咳嗽 7例 ,咳血痰或痰带血丝 5例 ,发热 3例 ,胸痛或胸闷不适 3例 ,无症状经体检…     

肺炎性假瘤的CT诊断

目的　加深对肺炎性假瘤CT表现特点的认识 ,以提高其CT诊断水平。方法　由 3名有经验的放射学医师按双盲法对48例经手术病理证实的肺炎性假瘤进行回顾性分析 ,然后共同讨论并达成一致意见。结果　在 48例肺炎性假瘤中 ,CT诊断正确者仅 9例 ( 18.7% ) ,其余被误诊为肺癌 2 1例 ( 5 3 .8% ) ,结核瘤 11例 ( 2 2 .9% ) ,良性病变 5例 ( 10 .4% ) ,错构瘤 2例 ( 4 .2 % )。虽然CT对肺炎性假瘤的诊断有一定的局限性 ,但肿块位于肺的外周、局限性胸膜增厚粘连、病灶边缘多发性空泡征、病灶下缘散在结节征、桃尖征、平直征及均匀强化等征象 ,对肺炎性假瘤的CT诊断具有重要意义。结论　全面综合地分析肺炎性假瘤的CT表现特征 ,并结合患者肺内感染病史对提高本病的CT诊断尤为必要。CT检查对于肺炎性假瘤的正确诊断与鉴别诊断是很有帮助的     

肝脏炎性假瘤的声像图表现(附23例分析)

目的探讨肝脏炎性假瘤(imflammatory pesudotumor of the liver,IPL)的声像学表现特点。方法回顾分析23例经手术或穿刺活检病理证实的肝脏炎性假瘤的声像学资料。结果B超多表现为不规则低回声,边界尚清,内部多无血流信号,少数内部可见低速、低阻的动脉血流频谱,部分多发病灶可见相互融合征象。结论IPL声像图上有一定的特征,但定性诊断较难,结合临床资料和其他影像学检查应能提高诊断率,确诊尚需依靠病理。