Zheng Nannan,Peng Xuehua,Gan Tongjia,et al.Imaging characteristics and diagnostic analysis of pediatric abdominal inflammatory myofibroblastic tumors[J].Journal of Clinical Pediatric Surgery,2025,(06):570-576.[doi:10.3760/cma.j.cn101785-202504010-012]
Imaging characteristics and diagnostic analysis of pediatric abdominal inflammatory myofibroblastic tumors
- Keywords:
- Neoplasms; Muscle Tissue; Inflammatory Myofibroblastic Tumor; Abdomen; Imaging; Three-Dimensional; Surgical Procedures; Operative; Child
- Abstract:
- Objective To investigate the clinicopathological characteristics of pediatric inflammatory myofibroblastic tumors (IMTs) and analyze the clinical value and diagnostic accuracy of multi-slice spiral CT (MSCT) in the diagnosis of abdominal IMTs. Methods This retrospective study analyzed the clinical data of 13 pediatric patients diagnosed with abdominal IMT by surgical pathology between August 2010 and September 2023.The patients were aged between 2 months and 6 years.All underwent MSCT plain and contrast-enhanced scanning using a SOMATOM CT scanner (tube voltage:80-100 kV,with automatic current modulation).The rotation speed was set at 0.8 s/360°,pitch at 0.984,and scan range from the diaphragm dome to the upper pubic symphysis.Iohexol (350 mg/mL) was used as the contrast agent.Original images were reconstructed at 0.6 mm thickness and processed using multi-planar reformation (MPR) and maximum intensity projection (MIP). Results Of the 13 children,12 underwent successful radical tumor resection,and 1 underwent biopsy for diagnosis.Tumor locations included the gastrointestinal tract (n=8),mesentery/greater omentum (n=6,with partial overlap),bladder (n=1),and liver (n=2,1 overlapping with other sites).Solitary lesions were observed in 10 cases,and multiple lesions in 3 cases.Laboratory results showed elevated white blood cell count in 5 cases,elevated C-reactive protein (CRP) in 9,decreased hemoglobin (HGB) in 8,and increased platelet count (PLT) in all cases.MSCT revealed diverse tumor morphologies:lobulated (n=5),quasi-round (n=7),and patchy (n=1).Well-defined margins were observed in 10 cases and ill-defined in 3.Intratumoral calcifications appeared in 3 cases.Tumor density was homogeneous in 5 and heterogeneous in 8.Among 9 cases undergoing contrast-enhanced scanning progressive enhancement was observed; 4 showed homogeneous and 9 showed heterogeneous delayed-phase enhancement.Based on enhancement degree,11 showed marked enhancement and 2 mild enhancement.Preoperative diagnosis was correct in 6 cases,while 7 were misdiagnosed or had inconclusive diagnosis. Conclusions Pediatric abdominal IMTs often involve multiple sites and display varied MSCT features.Integrating clinical and imaging characteristics can improve disease.
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Memo
收稿日期:2025-3-25。
通讯作者:闫学强,Email:yanxueqiang1@163.com