局限性胸膜纤维瘤的影像表现

Imaging manifestation of localized fibrous tumors of the pleura

目的:探讨胸膜局限性纤维瘤的影像特点,以提高对它的认识。方法:回顾性分析了2002年～2008年经穿刺及手术病理证实的12例局限性纤维瘤的影像表现。结果:12例均为单发性病灶,右侧7例,左侧5例。其中最小1例直径约3cm,3～10cm的4例,10～15cm的3例,4例大于15cm。12例X线平片均见病灶密度均匀,边界清楚,无肋骨及椎体的骨质破坏征象。CT平扫见病灶与胸壁紧密相连。较小病灶密度均匀,境界清楚,大病灶内可见斑点状低密度坏死区,但其边界光滑,相邻组织受压移位。CT平扫中12例病灶的CT值平均为33.4±5.7HU,而周边肌肉的CT值平均为52.9±6.2 HU,经两样本均数的t检验,P=0.0367(P<0.05)。3例增强扫描见病灶中等度强化,坏死区不强化。2例行MRI检查,T1WI见病灶呈类似肌肉的稍低信号,T2WI为与肌肉相似的等信号,坏死区为高信号。结论:局限性纤维瘤具有相对特征性的影像表现,CT、MRI均可显示其病变的范围及其性质。

Objective：To detect imaging features of localized fibrous tumors of the pleura（LFTP） so as to diagnose more accurately.Methods：12 cases from 2002 to 2008,with the LFTP proved by histopathology through biopsy or surgery,were retrospectively analyzed.Results：Seven LFTP were located in the right thoracic pleura,5 in the left thoracic pleura.Size of LFTP was various,i.e.,〈3 cm（1 case）,3～10 cm（4 case）,10～15 cm（3 case）,and 〉15 cm（4 case）.In chest X-ray,12 cases with well-defined margin and hemogeneous density were detected without destruction of adjecnt ribs and vertebra.In plain CT scan,density of all lesions（33.4±5.7 HU） were about 20 HU lower than that of muscle（52.9±6.2 HU） with t test P=0.0367（P〈0.05）.In enhanced CT scan of 3 cases,all lesions were moderately enhanced by contrast media but necrosis with lower density in plain CT scan were not enhanced.In MR scan of 2 cases,little low intensity in T1WI and iso-intensity in T2WI,like muscles＇ intensity,were demonstrated in the lesion.Conclusion：LFTP has sepical imaing feature,which is helpful to localize and quantify LFTP yealding correct and detail diagnosis.