头颈部炎性肌纤维母细胞瘤CT和MRI表现

目的 探讨头颈部炎性肌纤维母细胞瘤(IMT)的CT和MRI表现。方法 回顾性分析12例经手术病理证实的头颈部IMT患者的临床及影像学资料,9例接受CT平扫,其中7例接受增强CT扫描;4例接受MR平扫及增强扫描。结果 12例IMT均为单发,发生于上颌骨、颌面部软组织、上颌窦及颈部软组织各2例,下颌骨、眼眶、颧骨及腮腺各1例,肿瘤体积1.0 cm×1.0 cm×1.0 cm~5.0 cm×3.8 cm×4.8 cm。CT平扫7例密度均匀,2例密度不均匀,CT值30~85 HU,增强扫描6例轻至中度强化,1例明显强化;6例可见骨质被吸收破坏,呈压迫性或膨胀性溶骨改变,周围无硬化边和骨膜反应。MRI示软组织肿块,边界不清,T1WI呈等略低信号,T2WI呈等略高信号;增强后3例明显均匀强化,1例不均匀强化。结论 CT和MRI可清晰显示IMT部位、大小及周围改变,但无特异性,确诊需依赖病理检查。

CT and MRI features of head and neck inflammatory myofibroblastic tumors

Objective To investigate CT and MRI manifestations of inflammatory myofibroblastic tumor (IMT) located in head and neck. Methods Imaging and clinical data of 12 patients with IMT proved by pathology were retrospectively analyzed. Among 12 patients, 9 underwent plain CT scanning, 7 of them underwent enhanced CT scanning, while 4 patients underwent both plain and enhanced MR scanning. Results IMT in all the 12 cases present as single lesion, located in maxilla, soft tissue of maxillofacial region, maxillary sinus and neck (each n=2), and in mandible, orbit, zygomatic bone and parotid gland (each n=1). The volume of the lesions ranged from 1.0 cm×1.0 cm×1.0 cm to 5.0 cm×3.8 cm×4.8 cm. Plain CT showed 7 lesions with homogeneous density and 2 with hotergeneous density, with CT value ranged from 30 HU to 85 HU. Enhanced CT showed slight or moderate enhancement in 6 cases and significant enhancement in 1 case. Bone absorption and destruction with oppressive or expansive osteolysis changes were observed in 6 cases, while no bone sclerosis nor periosteal reaction was found. In MRI, the lesions were shown as soft tissue masses with unclear border, manifested as iso-hypointensity on T1WI and slightly iso-hyperintensity on T2WI. After administration of contrast, the lesions obviously and homogeneously enhanced in 3 cases, while inhomogeneously enhanced in 1 case. Conclusion CT and MRI can clearly demonstrate the location and dimension of IMT and the changes of surrounding tissues without specificity. The final diagnosis relies on pathology.