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目的探讨炎性肌纤维母细胞瘤(IMT)的超声表现,旨在提高对其诊断水平。方法回顾性分析21例经手术病理组织证实的IMT患者超声图像,其中男性13例,女性8例;年龄0.5~76.0岁,平均年龄45.1岁。分析病变的发生部位、大小、形态、边界、内部回声、血流信号及有无转移等特点。仅有5例腹腔IMT和2例盆腔IMT进行增强CT检查,余14例只做了超声检查。结果位于腹腔7例,位于盆腔4例,位于泌尿道2例,位于前臂、颈部、甲状腺、眼眶、阴囊、腹股沟、锁骨下、小腿各1例。13例瘤体最大径<5 cm,8例瘤体最大径>5 cm。14例瘤体边界清楚,7例瘤体边界不清楚。15例瘤体为低回声,6例为囊实混合回声。14例瘤体血流信号不丰富,7例血流信号丰富。仅1例IMT发生腹腔大网膜多发转移,余20例IMT未发现转移灶。免疫组织化学检测显示:肿瘤细胞表达Vimentin、SMA、MSA、Desmin,其阳性率分别为100%(21/21)、100%(21/21)、100%(21/21)、47.6%(10/21)。结论超声检查能清楚显示IMT的部位、大小、形态、边界、内部回声、血流信号及其有无转移等,但超声图的表现无特异性,确诊仍依赖病理学及免疫组织化学检查。
Objective To investigate the ultrasonographic features of inflammatory myofibroblastic tumor (IMT) in order to improve its diagnostic value. Methods A retrospective analysis of 21 cases of pathologically confirmed IMT patients with ultrasound images, including 13 males and 8 females; aged 0.5 to 76.0 years, with an average age of 45.1 years. Analysis of the lesion location, size, shape, boundary, internal echo, blood flow signals and whether the transfer characteristics. Only 5 cases of peritoneal IMT and 2 cases of pelvic IMT enhanced CT examination, the remaining 14 cases only made ultrasound examination. Results Seven patients were located in the abdominal cavity, 4 in the pelvic cavity, 2 in the urinary tract, and 1 in the forearm, neck, thyroid, orbit, scrotum, groin, clavicle and calf. The maximum diameter of 13 cases was less than 5 cm and the maximum diameter of 8 cases was> 5 cm. 14 cases of tumor clear boundary, 7 cases of tumor boundary is not clear. Fifteen tumors were hypoechoic and six were echogenic mixed echoes. 14 cases of tumor blood flow signal is not rich, 7 cases of blood flow signal rich. Only 1 case of IMT occurred peritoneal omentum multiple metastases, the remaining 20 cases of IMT found no metastases. Immunohistochemistry showed that the positive rates of Vimentin, SMA, MSA and Desmin in tumor cells were 100% (21/21), 100% (21/21), 100% (21/21) and 47.6% /twenty one). Conclusions Ultrasonography can clearly show the location, size, shape, boundary, internal echo, blood flow signal and its metastasis of IMT, but the manifestation of ultrasound is not specific. The diagnosis is still dependent on pathology and immunohistochemistry.