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Objective·To investigate the imaging features of computed tomography (CT) and magnetic resonance imaging (MRI) in the patients with Kimura disease (KD) in the head and neck.Methods·Sixty-four cases of KD in the head and neck comfirmed by histopathology were retrospectively collected from 2009 to 2023 in Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine. All patients completed CT and/or MRI enhancement imaging before surgery. Clinical and imaging characteristics were collected, recorded and analyzed, including age, gender, peripheral blood eosinophilic ratio, serum IgE level, the lesion location, shape, size, CT density and degree of enhancement, MRI signal intensity and degree of enhancement, apparent diffusion coefficient (ADC), time-signal intensity curve (TIC) patterns, wash-in rate, and time to peak (TTP).Results·The average age of the 64 KD patients was (40±19) years, and 92.2% were males. A total of 73.5% of the patients showed an elevated ratio of peripheral blood eosinophil, and all 10 tested patients exhibited increased serum IgE levels. There were 82 extranodal (subcutaneous and glandular) lesions and 144 lymph node lesions detected by CT and MRI. Among the extranodal lesions, 80.5% were subcutaneous or glandular patchy lesions with unclear boundaries, and the rest were nodular lesions with clear boundaries. All lesions exhibited isodensity on CT scans and showed isointensity on T1-weighted imaging (T1WI) and hyperintensity on T2-weighted imaging (T2WI) in MRI. Most extranodal lesions tended to show heterogeneous enhancement, while most lymph node lesions showed homogeneous enhancement. The median ADCs of the extranodal lesions and the lymph node lesions were 1.04×10-3 mm2/s and 0.67×10-3 mm2/s, respectively, which were significantly different (P=0.000). The dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) results showed that the TIC patterns of extranodal lesions were predominantly type Ⅰ and Ⅱ, accounting for 57.5% and 42.5%, respectively; while the TIC patterns of lymph node lesions were predominantly type Ⅱ (96.6%). The difference in the TTP and the wash-in rate between the extranodal lesions and the lymph node lesions were both statistically significant (P=0.000).Conclusion·Extranodal lesions and lymph node lesions of KD both show isodensity on CT, and isointensity on T1WI and hyperintensity on T2WI in MRI. Extranodal lesions often show high ADC, TIC type Ⅰ or Ⅱ, and mostly heterogeneous enhancement; lymph node lesions often show low ADC, TIC type Ⅱ, and mostly homogenous enhancement.

Globally, a great number of children have been suffering from physical dysfunction and psychological stress due to uncontrollable scar growth and a lack of effective modalities. Despite chemotherapy's established role as a primary treatment for pathological scarring in adults, its efficacy in preventing or minimizing scar formation in paediatric patients remains underexplored. This retrospective cohort study aimed to refine the relevant clinical evidence and investigate the effect of chemotherapy on pathological scars in children. In this single‐centre retrospective cohort study, the data of children aged ≤18 years who underwent thoracic surgery at the Children's Hospital of Fudan University between 1 January 2018, and 31 December 2021 were assessed. The primary outcome was pathological scarring, and the secondary outcomes were subjective symptoms accompanying pathological scarring, such as pain and itching. To mitigate indication bias, analysis was performed by inverse probability weighting (IPTW) log‐binomial regression models. The cohort comprised 102 children, among whom 36 received adjuvant chemotherapy perioperatively, while 66 did not. Under the IPTW model, a statistically significant difference in pathological scarring incidence was observed between the chemotherapy and non‐chemotherapy groups (16.7% vs. 29.4%, p = 0.027). And the children received chemotherapy post‐operatively had a lower relative risk of pathological scarring, compared with those received chemotherapy both before and after surgery (19.8% vs. 28.8%). Adjuvant chemotherapy treatment after surgery may reduce the incidence of post‐operative pathological scarring in children. [ABSTRACT FROM AUTHOR]