CT and MRI features of 29 patients with inflammatory myofibroblastic tumor in the head and neck

doi:10.19438/j.cjoms.2022.05.014

Abstract

Abstract: PURPOSE: To analyze the imaging features of inflammatory myofibroblastic tumor (IMT) in the head and neck through CT and MRI, and improve the correct diagnosis of the tumor before operation. METHODS: From January 2012 to December 2018, a total of 29 patients with IMT in the head and neck who were initially diagnosed and confirmed by postoperative pathology were retrospectively collected in Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine. Their preoperative CT and MRI findings were analyzed. RESULTS: Of the 29 patients with IMT in the head and neck, 67.0%(20/29) were misdiagnosed as malignant tumors before operation. The imaging findings of IMT in the head and neck were varied, 7 cases were identified as localized soft tissue mass, 12 cases with soft tissue mass and adjacent bone destruction (5 in the infratemporal fossa, 6 in the maxillary sinus, 1 in the wide maxillofacial region), and 10 cases with intraosseous mass (5 in the maxilla, 4 in the mandible, 1 in the temporal bone). 89.7%（26/29）were presented as uneven margins. 75.9%（22/29）showed bone destruction, 34.5%（10/29）with hyperostosis and remodeling. Eight cases had a peri-neural infiltration(6 cases occurred in the infratemporal fossa, with 4 cases suffered from invasion through foramen rotundum and foramen ovale, 2 cases invaded the optic canal, 2 cases occurred in the mandible and invaded the mandibular nerve canal). The IMT in the head and neck showed isodense or slightly hypodense, with no calcification on CT plain scan, and moderate/marked enhancement after contrast-enhanced scanning. MRI showed 9 cases with isointense or hypointense on T1 weighted images, 7 cases with hypointense on T2 weighted images, 9 cases with hyperintense on DWI. The range of ADC value of IMT (9 cases) was about (0.6-1.0)×10^-3mm²/s. The TIC type of 7 cases was typeⅠ, and 2 cases with typeⅡ. There were no cervical lymph node metastasis and distant metastasis. CONCLUSIONS: IMT in the head and neck has certain imaging characteristics that are commonly found in malignant tumors. However, IMT in the head and neck can erode and remodel bone, with striped hypointense on T2 weighted image, mostly type I, few cervical lymph node metastasis and distant metastasis. CT, MRI and functional examination can reflect the tissue composition of the lesion to a certain extent, and provide an important basis for the correct preoperative diagnosis.

Key words: Inflammatory myofibroblastic tumor, Head and neck, CT, MR imaging

CLC Number:

R739.8

WANG Can, ZHANG Chun-ye, TAO Xiao-feng, WANG Bo-cheng, ZHU Ling. CT and MRI features of 29 patients with inflammatory myofibroblastic tumor in the head and neck[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(5): 494-499.

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