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目的探讨肌内黏液瘤的CT和MRI表现,以提高对该病的诊断水平。方法回顾性分析经手术病理证实的16例肌内黏液瘤的CT和MRI表现,其中男7例,女9例,年龄2~66岁,中位年龄47岁。对肿瘤的部位、大小、形态、边缘、信号或密度、强化方式及周围情况进行分析。结果 16例中位于四肢9例,盆部2例,胸壁2例,腹壁2例,肩部1例。最大径约2.1~11.4 cm,平均(5.1±2.3)cm。13例病灶形态规则、边界清晰,3例形态不规则、局部边界不清。6例CT平扫表现为低密度,3例周围软组织可见脂肪帽;3例CT增强扫描中,2例表现为边缘轻度环形强化,1例表现为边缘环形强化并内部结节状强化。9例病灶T_1WI表现为低信号,11例病灶T_2WI及T_2抑脂序列均表现为显著高信号;MRI增强扫描3例表现为边缘环形强化,其中2例伴分隔线状强化;1例表现为显著强化;6例不均匀轻中度强化,其中3例多期增强扫描可见渐进性强化。9例T_2抑脂系列病灶周围软组织可见水肿信号,5例T_1WI病灶周围软组织可见脂肪沉积信号。结论肌内黏液瘤的CT和MRI表现具有一定特异性,大块肌肉内类似囊样肿块,不均匀延迟强化、边缘环形强化或分隔线状强化,周围软组织伴脂肪沉积及灶周水肿,可提示肌内黏液瘤的诊断。
Objective To investigate the CT and MRI findings of intramuscular myxoma in order to improve the diagnosis of this disease. Methods The CT and MRI findings of 16 cases of intramuscular myxoma confirmed by surgery and pathology were retrospectively analyzed. There were 7 males and 9 females, aged 2 to 66 years, with a median age of 47 years. The tumor location, size, shape, margins, signal or density, fortification and surrounding conditions were analyzed. Results Among the 16 cases, there were 9 limbs, 2 pelvis, 2 chest wall, 2 abdominal wall and 1 shoulder. The maximum diameter is about 2.1 ~ 11.4 cm, with an average of (5.1 ± 2.3) cm. Thirteen lesions were regular in shape, the border was clear, three cases were irregular in shape, and the local border was unclear. 6 cases of CT showed low density, three cases of visible soft tissue around the fat cap; 3 cases of enhanced CT scan showed mild edge enhancement in the edge, 1 case showed edge ring enhancement and internal nodular enhancement. T_1WI showed low signal in 9 cases, and high signal in T_2WI and T_2 in 11 cases. The enhanced MRI showed enhanced ring edge in 3 cases, 2 cases with linear enhancement and 1 case showed significant Enhanced; 6 cases of uneven mild to moderate enhancement, including 3 cases of multi-phase enhanced scan shows progressive enhancement. The edema signal was found in the surrounding soft tissues of 9 cases of T 2 fat suppression lesion, and the fat deposition signal was seen in the surrounding soft tissues of 5 cases of T 1 WI lesion. Conclusion Intramyocular myxoma has certain CT and MRI manifestations. The intracranial myxoma is similar to the cystoid mass, uneven lag intensification, peripheral annular enhancement or separation of linear enhancement, surrounding soft tissue with fat deposition and perifocal edema, which may suggest Diagnosis of intramuscular myxoma.