目的分析纵隔炎性肌纤维母细 胞瘤的螺旋CT表现，提高对该病的诊断 及鉴别诊断能力。方法 回顾性分析经手 术病理证实的7例纵隔炎性肌纤维母细胞 瘤的螺旋CT表现。结果 病变位于前纵隔 1例，中纵隔3例，后纵隔3例。螺旋CT像 上均表现为实性肿块，前纵隔病变中病 灶边界清晰；而中纵隔病例中3例则边界 不清，其中2例侵犯气管壁，1例侵犯食 管壁。后纵隔1例边界不清，侵犯相邻肋 骨，余后纵隔2例边界清晰，其中1例可见 钙化。增强扫描呈轻度均匀强化1例，中 度均匀强化4例，重度均匀强化2例。随访 显示1例复发。结论 纵隔炎性肌纤维母细 胞瘤螺旋CT表现为均匀密度软组织肿块， 增强后呈轻度、中度均匀强化，部分病灶 边缘清楚，部分不清楚。螺旋CT检查可显 示肿瘤的范围及与相邻组织解剖关系，对 确定手术的可切除性有重要价值。

Objective To improve the accuracy rate of the diagnosis and differential diagnosis of inflammatory myofibroblastic tumor in the mediastinum by analyzing spiral computed tomography (CT) images. Methods Retrospective analysis of the clinical data and spiral CT features of 7 patients who had been confirmed inflammatory myofibroblastic tumor by postoperative pathology in the mediastinum. Results there was 1 patient whose lesions were in anterior mediastinum, 3 in middle mediastinum and posterior mediastinum respectively. All lesions were solid soft tissue mass. The case of anterior mediastinum had a clear boundary. The tumors of middle mediastinum did not have clear boundaries, two of the three invaded the right wall of trachea, while another one invaded esophageal wall. The tumor in right posterior mediastinum destroyed the structures of neighboring ribs, the other two cases in the posterior mediastinum have a clear boundary. A small amount of calcification was seen in the case of right posterior mediastinum. After administration of contrast material, mild, moderate and severe homogeneous enhancement patterns were found in 1,4,and 2 cases, respectively. Recurrence was found in 1 case. Conclusion Typical spiral CT imaging presentation of IMT in the mediastinum is as a soft-tissue mass with uniform density. A moderate homogeneous enhancement pattern is usually seen after administration of contrast material. Some lesions have clear boundaries, some do not. Spiral CT examination can help to determine lesion areas and relationship with adjacent tissues, and thus to facilitate the prediction of feasibility for surgical excision.