背部弹力纤维瘤的多排螺旋CT及MRI诊断

目的探讨多排螺旋CT(multidetector spiral computed tomography,MSCT)及磁共振成像(magnetic resonance imaging,MRI)诊断背部弹力纤维瘤(elastofibroma dorsi,EFD)的影像学特点。材料与方法收集我院20例经手术病理证实的EFD患者资料,所有患者均行CT检查,其中8例行CT增强检查,4例行MRI检查,1例同时行MRI增强检查,3例MRI平扫检查,并分别测量EFD、前锯肌及周围脂肪CT平扫及增强后CT值进行比较,分析EFD的临床特点及CT、MRI表现。结果 20例患者中,13例病灶位于双侧,4例病灶位于右侧,3例病灶位于左侧,CT共发现33处病灶,并均位于背部肩胛下角肌肉深面,均呈扁丘状或半圆形肿块,主要以肌肉样密度为主,病灶内见条纹状脂肪密度沿病灶长轴间隔排列;病灶边缘毛糙不整,周围脂肪间隙模糊不清,CT增强扫描3例轻度强化,5例无强化;EFD与前锯肌、EFD与周围脂肪间平扫及增强CT值差异均存在统计学意义(P0.05);MRI平扫信号不均匀,呈等信号为主的肌组织与高信号的脂肪组织交错排列,MRI增强扫描1例呈不均匀中度强化。结论背部弹力纤维瘤具有典型的发病部位,根据CT及MRI影像表现均可做出明确诊断。

The diagnosis of lastonfibroma on dorsi by multi-slice computed tomography and magnetic resonance imaging

Objective: This study was to investigate multi-slice spiral computed tomography (MSCT) and magnetic resonance imaging (MRI) appearances of elastofibroma dorsi (EFD). Materials and Methods: 20 cases of elastofibroma dorsi which were confirmed by pathology after surgical resection were retrospectively reviewed. All patients were examined with CT, 8 of them underwent CT enhancement examination, 4 of 20 patients were examined with MRI, and 1 patient underwent MRI enhancement examination, and other 3 without enhancement. The CT values of EFD, anterior serratus muscle and surrounding fat were measured by CT and compared with that of the other groups respectively. Clinical manifestations, features of CT and MRI of elatofibroma dorsi were analyzed. Results: It was bilateral in 13 patients of 20 patients, right lateral in 4 patients and 3 patients occurred in left lateral. 33 lesions were found by MSCT, all of them were located in the deep subscapular region, presented as flat hummocky and semicircular soft-tissue mass, all tumours had almost equal density as muscle, with some Strap-shaped fat-liked density along the longitudinal of the mass. The mass was poorly circumscribed, surrounded by ambiguous adipose space. On enhanced CT scan, 3 lesions showed slight enhancement, others didn't show any extent of enhancement, there was statistical difference of CT values between EFD and anterior serratus muscle, while the same result of EFD and fat (P<0.05). On MRI plain scan, the tumour showed heterogeneous signals of iso-intensity of muscle and hyper-intensity of fat. As to the case with enhanced MRI scan, moderately heterogeneous enhancement was observed. Conclusion: Elastofibroma dorsi has its specific location, definite diagnosis could be made according to the features of MSCT and MRI imagings.