MRI诊断背部弹力纤维瘤

目的 探讨背部弹力纤维瘤的MRI表现和诊断价值.方法 回顾性分析14例经MRI及手术病理证实的背部弹力纤维瘤,其中3例接受患侧肩部平扫,6例接受胸部平扫,5例接受胸部平扫及增强,2例同时进行了延迟增强扫描,分析其临床及MRI表现特点.结果 14例均为女性,年龄47~78岁,病灶均位于背部肩胛下角区肌肉深面与胸壁之间的脂肪间隙内,14例中有9例为双侧病灶,除了临床表现为双侧病变的5例外,4例为临床表现为单侧病变而胸部MR检查发现对侧有较小的亚临床阶段病灶.MR检查共发现23个病灶.背部弹力纤维瘤在轴位及冠状位呈扁丘状,矢状位呈类圆形;T1WI和T2WI均呈条纹状间隔排列的骨骼肌样低信号和脂肪样高信号,脂肪抑制序列脂肪样高信号被抑制,7个病灶内见小的局灶性囊变;病变边缘不整.增强扫描中5例9个病灶见条纹状、斑片状中等强化,2例4个病灶延迟增强扫描呈进行性强化.结论 中老年女性双侧或单侧肩胛下角区扁丘状肿块,MRI表现为骨骼肌样低信号与脂肪样高信号条纹状间隔排列、条纹状及斑片状中等强化者,应考虑背部弹力纤维瘤.双侧同时检查有利于发现亚临床阶段病变.

MRI diagnosis of elastofibroma dorsi

Objective To explore the MR findings of elastofibroma dorsi. Methods Fourteen patients with elastofibroma dorsi confirmed by pathology were collected retrospectively. Three patients underwent plain unilateral shoulder MRI. Six patients underwent plain chest MRI. Five patients underwent both plain and contrast-enhancement MRI. Clinical features and MR characteristics of elastofibroma dorsi were analyzed. Results Fourteen patients were all female, aged from 47 to 78 years old. All lesions located in the deep subscapular muscle between the chest walls in the back. Nine patients were bilateral lesions, including 4 lesions in the sub-clinical stage. Totally 23 lesions were found with MRI. Mass were flat mound-like, poorly circumscribed, fasciculated pattern of skeletal muscle-like hypointense and fatty hyperintense signal intensity on both T1- and T2-weighted images. Focal small cystic change was found in 7 lesions. Nine lesions in 5 patients were moderately stripes and patchy enhanced and 4 lesions in 2 patients showed progressive enhancement on delayed imaging. Conclusion Elastofibroma dorsi should be considered when a bilateral or unilateral subscapular areas mass presenting as skeletal muscle-like hypointensity with striated fat hyperintensity, moderately stripes and patchy enhanced on MRI in middle-aged women. Bilateral examination is necessary for detecting sub-clinical stage lesions.