本文選題：胸部腫瘤 + 橫紋肌肉瘤　； 參考：《中國醫(yī)學影像學雜志》2015年12期

【摘要】：目的原發(fā)于胸壁的橫紋肌肉瘤(RMS)少見,關于兒童胸壁RMS影像學表現的研究較少,本文分析了兒童胸壁RMS的CT影像學表現,以提高兒童胸壁RMS的診斷準確率。資料與方法回顧性分析經手術病理證實為胸壁RMS的5例患兒的CT影像資料,總結患兒RMS的CT影像特點。結果 5例患兒中,病灶位于前胸壁1例,后胸壁2例,側胸壁(腋下)2例。病灶形態(tài)呈類圓形或梭形,部分腫塊呈淺分葉。平掃病灶密度不均勻、可見斑片狀低密度壞死區(qū)2例,密度較均勻3例;5例病灶均未見鈣化及脂肪組織。腫塊侵犯鄰近椎管1例;腫塊突入胸腔壓迫肺組織1例,壓迫心臟及肝臟1例;腫塊包繞血管生長2例。5例病灶均緊鄰肋骨、肱骨、肩胛骨及脊柱骨等,有骨質破壞1例。增強掃描5例病灶呈不均勻輕-中強化,以周邊強化明顯,病灶內可見較多增粗、扭曲的供血動脈影,其內壞死區(qū)不強化。2例出現肺轉移灶,1例出現胸腔積液及腹腔積液,1例出現淋巴結轉移。結論兒童胸壁RMS的CT表現為胸壁較大或巨大軟組織腫物,密度均勻或欠均勻,內無鈣化及脂肪組織,部分有壞死區(qū),鄰近組織受推壓甚至侵犯,可出現淋巴結及遠處轉移;增強掃描后病灶呈不均勻輕-中度強化,以周邊強化明顯。結合臨床表現,綜合分析增強CT影像表現可提高診斷準確率。
[Abstract]:Objective RMS (rhabdomyosarcoma of the primary chest wall) is rare, but there are few studies on the RMS imaging findings of the chest wall in children. The CT imaging findings of the chest wall RMS in children were analyzed in order to improve the diagnostic accuracy of the chest wall RMS in children. Materials and methods CT images of 5 children with chest wall RMS proved by operation and pathology were analyzed retrospectively and the CT features of RMS were summarized. Results in 5 cases, the lesions were located in the anterior chest wall in 1 case, the posterior chest wall in 2 cases, and the lateral chest wall in 2 cases. The shape of the lesion was round or fusiform, and part of the mass was shallowly lobulated. The density of the lesions on plain scan was not even, and there were 2 cases of low density necrotic areas in plaque shape, and 3 cases were more homogeneous in density. No calcification and adipose tissue were found in 5 cases. One case involved the adjacent spinal canal, one case was the mass protruding into the thoracic cavity, one case was pressing the lung tissue, one case was pressing the heart and liver, and two cases (5 cases) with the tumor around the blood vessel grew close to the ribs, humerus, scapular and spinal bones, and 1 case had bone destruction. Enhanced scanning showed uneven light and moderate enhancement in 5 cases, with obvious peripheral enhancement, with more thickening and distorted arterial shadows in the lesions. Pulmonary metastasis was found in 1 case with pleural effusion and 1 case with lymph node metastasis. Conclusion the CT findings of RMS in children's chest wall are large or large soft tissue masses with uniform or uneven density, no calcification and adipose tissue, some necrotic areas, the adjacent tissues may be pushed or even invaded, lymph nodes and distant metastasis can occur. The lesions showed uneven mild to moderate enhancement, especially peripheral enhancement. Combined with clinical manifestations, comprehensive analysis of enhanced CT images can improve the diagnostic accuracy.
【作者單位】： 南方醫(yī)科大學;南方醫(yī)科大學第五附屬醫(yī)院影像科;廣州市婦女兒童醫(yī)療中心放射科;南方醫(yī)科大學南方醫(yī)院影像診斷中心;
【分類號】：R738.6;R730.44

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本文編號：1989341