目的:探讨头颈部炎性肌纤维母细胞瘤的影像学表现及临床特征,提高该病的术前诊断水平.方法:回顾性分析收治11例病理确诊头颈部炎性肌纤维母细胞瘤患者的临床特征以及CT、MRI表现.结果:11例患者中8例临床上表现为进行性增大的无痛性头颈部肿块,2例表现为面部肿胀,1例表现为进行性眼球突出,72.7％(8/11)在术前临床诊断为恶性肿瘤.11例患者均在术前行CT或MRI检查,其中6例行MRI检查,3例行CT检查,2例同时行CT和MRI检查.头颈部炎性肌纤维母瘤在CT和MRI上表现与恶性肿瘤相近.11例患者共发现15个病灶,其中86.7％病灶(13/15)边界不清楚,侵犯临近肌肉,46.7％(7/15)病灶有骨质侵犯.3例患者出现神经孔道侵犯,其中2例为发生于咀嚼肌间隙病灶沿圆孔和卵圆孔向颅内侵犯,1例为发生于眼眶视神经管侵犯.头颈部炎性肌纤维母瘤在CT平扫时呈稍低密度,增强扫描呈明显强化.在MRI上表现为:T1W上呈稍低于肌肉信号,在T2WI上信号强度低于或等于信号肌肉,信号明显不均匀,增强扫描呈明显不均匀强化.结论:头颈部炎性肌纤维母细胞瘤在临床表现及影像学特征上与恶性肿瘤相近.但是MRI可以在一定程度上反映病灶的组织构成,对诊断和鉴别诊断具有重要作用.%Objective: This work aims to present the imaging and clinical features of inflammatory myofibroblastic tumor (IMT) in the head and neck region to improve its diagnostic accuracy. Methods: Clinical records and computer tomography (CT) and magnetic resonance imaging (MRI) findings of 11 cases with head and neck IMT treated in Cancer Center of Sun Yat-sen University, Guangzhou, China, were retrospectively reviewed. Results: A total of 15 lesions were found in these cases. Of all the 11 patients, 8 showed painless masses with rapid development, 2 had face swelling, and 1 had progressive exophthalmoses. In this study, 72.7% (8/9) of the patients were diagnosed to have malignant tumors before the surgery. Of all the patients, 6 underwent MRI scans before surgery, 3 underwent CT scans, and 2 received both MRI and CT scans. Of the 15 lesions found in our study, 13 (86.7%) were ill-defined and suffered involvements of the adjacent muscles, whereas 7 (46.7%) had osseous invasions. Among the patients, 3 had a peri-neural infiltration, 2 suffered from invasion through both foramen rotundum and foramen ovale, and 1 was invaded through the optic canal. As shown in the plain film CT scans with even and uneven images, the IMT appeared slightly hypodense with respect to adjacent muscles and then presented a strong enhancement after contrast-enhanced scanning. Calcification or necrosis is uncommon. The MRI features showed heterogeneously mild hypo-intensity on T1-weighted images, heterogeneously low signal on T2-weighted images, and strong enhancement on contrast-enhanced T1WI. Conclusion: IMT in the head and neck region exhibits a high local invasiveness but does not metastasize. It has some imaging characteristics that are commonly found in malignant tumors. MRI features help distinguish this tumor from other kinds of neoplasm.
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