儿童臀部纤维瘤病的CT表现与病理对照

目的探讨CT对儿童臀部纤维瘤病的诊断价值。方法回顾性分析8例儿童臀部纤维瘤病的CT表现。其中男7例,女1例;年龄2～ll岁。全部病例均经手术病理证实。对照病理征象,探讨CT表现的病理基础。结果7例发生于左臀,1例发生于右臀。CT征象表现为椭圆形或分叶状肿块;单块肌肉受累者3例,2块以上肌肉受累者5例;边缘均较清晰;爪状浸润者7例;平扫瘤内密度较均匀,与同层肌肉比较呈等密度者5例,稍低密度者3例;肿瘤内部无出血、坏死、囊性变及钙化;7例肿瘤增强扫描明显强化,1例与肌肉等密度强化;7例肿瘤沿肌肉长轴及筋膜间隙浸润性生长;6例肿瘤邻近未受累肌肉受压萎缩。临床症状主要为跛行。病理诊断均为儿童臀部纤维瘤病。结论儿童臀部纤维瘤病的发病年龄、性别、部位及CT表现有一定的特征。CT征象与病理表现一致,有助于该病术前正确诊断和鉴别诊断,可准确评估肿瘤侵犯范围以及与周围结构的关系。

Child gluteal aggressive fibromatosis: a correlative study of CT findings and pathology

Objective To evaluate CT imaging in the diagnosis of child glute al aggressive fibromatosis. Methods CT manifestations of child gluteal aggressive fibromatosis were retrospectively analyzed. In total 7 males and 1 female, 2 to 11 years old, were enrolled in study. All cases had been confirmed by surgery an d pathology. CT findings were correlatively studied with pathology. Results Lesi ons located on the left side were noted in 7 cases, and a lesion located on righ t side was seen in the rest 1 case. The lesions were elliptical or lobulated on CT images. Three tumors originated from solitary muscle and multiple muscles wer e involved in other 5 cases. Tumors were well demarcated. Invasion to the adjace nt structure was shown in 7 cases. All tumors were homogeneous in density in non -enhanced scan. Compared to the muscles in the same section, 5 tumors were iso -density and 3 tumors were hypo-density. Inside the lesions no hemorrhage, nec rosis, cystic degeneration and calcification was revealed. After contrast medium was administrated, iso-dense and homogeneous enhancement as the adjacent muscl es was seen in 1 tumor and apparent enhancement were demonstrated in 7 tumors. S even tumors tended to grow along the longitudinal axis of muscles and infiltrate d into fascial space. Atrophy resulting from compression was shown in the adjace nt muscles in 6 cases. The major clinical manifestation was limp. Gluteal aggres sive fibromatosis was confirmed by pathology in all cases. Conclusion There are characteristics of child gluteal aggressive fibromatosis in age of onset, gender of the patients, site of the lesion and CT findings as well. CT manifestations were consistent with pathology. CT imaging is helpful in initial diagnosis and d ifferential diagnosis, as well as in assessing the expansion of the tumor and in volvement of the adjacent structures.