摘要
目的探讨MRI和CT对结节性筋膜炎（NF）的诊断价值。方法回顾性分析8例NF患者的临床、影像及病理资料,其中6例行MRI检查,2例行CT检查。结果 8例NF中,位于上肢5例,位于颈部、胸部、下肢各1例,大小1.5～5.0 cm。皮下型均表现为皮下小结节影,伴周围软组织水肿;肌内或肌间型表现为结节状或不规则形实性肿块,边界清楚或呈浸润性生长。CT平扫显示肿块密度与肌肉密度相仿,边界清楚或伴少许渗出。MRI表现与组织学构成相关,本组病例组织学上可分为黏液型6例,细胞型1例以及纤维瘤、黏液混合型1例,大多数病灶在T1WI上呈均匀等信号,T2WI则以高信号为主,可伴钙化或囊变,增强扫描病变呈中、重度强化,可不均匀。结论NF影像学表现与病程和病理类型有一定相关性。一些特征性表现,如皮下型表现为皮下结节伴水肿,以及＂靶征＂或＂筋膜尾征＂,有助于诊断,但最终确诊还需密切结合临床。
Objective To discuss the clinical value of MRI and CT scan in the diagnosis of nodular fasciitis （NF）. Methods Clinical data, imaging pathological materials of 8 patients with NF were retrospectively analyzed. MRI was per- formed in 6 patients and CT scan in 2 patients. Results Of 8 patients with NF, the lesion was located at upper extremity in 5, at neck in one, at chest in one and at lower extremity in one. The sizes of the tumors ranged from 1.5 to 5 cm in diameter. The subcutaneous NF appeared as little nodules with edema of adjacent soft tissue. The intramuscular and fascial type NF appeared as a well-defined or infiltrative solid mass. The CT value was similar to muscle. On MRI the lesion＇ s signal was related to its pathological type. Pathologically, mucoid type was seen in 6, cellular type in one and mucoid-fi- brous mixed type in one. Most lesions manifested themselves as iso-intense signal on T~ WI and hyper-intense signal on T2WI, with moderate to significant, homogeneous or heterogeneous, enhancement after contrast injection. Conclusion MRI manifestations of NF bear certain relationship with the course of disease and the histological subtypes. Some special appearances, such as subcutaneous nodule with edema, ＂target sign＂ and ＂fascia tail sign＂, are helpful for diagnosis, although the confirmation of the diagnosis should be closely combined with clinical information.
出处
《临床放射学杂志》
CSCD
北大核心
2015年第5期773-776,共4页
Journal of Clinical Radiology
