Abstract
BackgroundThe aim of this study was to characterize the radiological features of myofibroma on multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) and correlate the imaging findings with pathologic features.MethodsThe radiological findings of 24 patients with 29 myofibromas were retrospectively reviewed. All images were evaluated with emphasis on density, signal intensity, hypointense area, and enhancement, correlating these with pathologic findings.ResultsOn plain MDCT scan, 4(26.7%) tumors were homogeneous isodensity, 4(26.7%) tumors were heterogeneous hyperdensity, and 7(46.7%) tumors were heterogeneous hypodensity. On contrast-enhanced MDCT scan, all tumors (9/9) showed heterogeneous enhancement with moderate in 3(33.3%) and marked in 6(66.7%) tumors, and their enhancements were higher compared to adjacent skeletal muscle (P = 0.0001). On MRI, heterogeneous slight hyperintensity, homogeneous slight hyperintensity, and heterogeneous hypointensity on T1-weighted imaging (T1WI) were observed in 14(82.3%), 1(5.9%) and 2(11.8%) tumors, respectively. On T2-weighted imaging (T2WI) and fat-suppressed (FS) T2WI, all tumors demonstrated heterogeneous hyperintensity. All tumors showed heterogeneous marked enhancement on FS contrast-enhanced T1WI. On T1WI, T2WI, FS T2WI, and FS contrast-enhanced T1WI, irregular strip or/and patchy hypointensities were found in 16(94.1%), 12(100%), 17(100%) and 17(100%) tumors, respectively, and pseudocapsule was seen in 5(29.4%) tumors. The hypointensities and pseudocapsule on MRI were exactly corresponding to pathological interlacing collagen fibers and fibrosis. The age of the recurrent group was lower than that of the non-recurrent group (P = 0.001) and the tumors without pseudocapsule were more likely to recur than those with pseudocapsule (P = 0.034).ConclusionMyofibromas are characterized by heterogeneous density or signal intensity, with moderate or marked enhancement. The hypointensities and pseudocapsule on MRI may be helpful in diagnosis, and the absence of pseudocapsule and younger age may be risk factors for tumor recurrence.
Highlights
The aim of this study was to characterize the radiological features of myofibroma on multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) and correlate the imaging findings with pathologic features
Our study aimed to describe the multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) findings of the myofibroma and to correlate them with pathologic features, in order to improve the diagnostic accuracy of preoperative radiological examinations
Myofibromas could occur at any bone, the cranioorbito-facial bones were most often involved with a solitary lesion, while, the other bone lesions were frequently observed with the multicentric type (17–77%) [2, 7, 15,16,17,18]
Summary
The aim of this study was to characterize the radiological features of myofibroma on multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) and correlate the imaging findings with pathologic features. Three clinical types of myofibroma are recognized: (1) solitary type (a single lesion in the skin, subcutaneous tissue, muscle, bone or viscus), (2) multicentric type (multicentric lesions limited to skin, subcutaneous tissues, muscles, and bones, without visceral involvement), (3) generalized type (multicentric lesions with visceral involvement) [2, 13]. In these types of myofibroma, the solitary form is the most common type, multicentric type with nonvisceral lesions accounts for the majority of familial-related myofibromatosis [2]. Spontaneous involution is common, the solitary type and multicentric type with single (or limited) visceral lesion have a better prognosis than the multicentric type with multiple visceral lesions [2, 14]
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