孤立性纤维瘤临床及影像诊断探讨(附3例报告并文献复习)

Clinical manifestations and imaging features of solitary fibrous tumor:a report of 3 cases and review of the literature

目的探讨孤立性纤维瘤的临床及影像学特点,提高对该疾病的诊断水平。方法回顾性分析3例经穿刺活检与手术病理证实的孤立性纤维瘤临床及影像学资料,并作文献复习。结果孤立性纤维瘤在临床上可无临床症状或因肿瘤压迫出现不典型症状,发生于胸膜的巨大孤立性纤维瘤可以合并低血糖症。在超声上表现为不均匀中等或中低回声;在X线平片上表现为均匀致密的孤立性肿块;在CT上1例表现为巨大囊实性肿块,增强后实性部分中度强化,另1例为均匀致密的软组织肿块;在MRI上肿瘤实性部分表现为在T1WI上呈中、低混杂信号,T2WI上呈低信号,肿瘤内可见明显囊变区。结论孤立性纤维瘤是一种少见疾病,必须结合既往病史、临床症状、各种影像学资料综合分析,才有可能作出准确的诊断。

Objective To explore the clinical manifestations and imaging features of solitary fibrous tumor（SFT）so as to improve the dignostlc accuracy. Methods The clinical and imaging data of 3 patients with clinically and pathologically proved SFT were analzed and the relative literatures were reviewed, Results Some of patients with SFT lacked clinical symptoms or presented atypical symptoms due to the oppression of tumor but some could associate with bypoglycemia when giant SFT occurred in the pleura. On ultrasonic images the lesions of SFT were nonhomogeneous isoecho or hypoecho. On X-ray plain films the lesions were homogeneous and dense solitary massos. On CT images the lesion of one case was large cyst-solid mass and solid part of the mass was middling enhancement after administration of contrast agent while that of another case was homogeneous and dense soft tissue mass. On MR T1 weighted images the solid part of the mass was intermediate and low heterogeneous intensity while on T2WI the lesion was hypointensity associated with the occurrence of intratumoral cyst-changing region. Conclusion SFT is a rare disease. Its accurate diagnosis needs an overall analysis combined with medical history, clinical symptoms and various imaging data.