腹部及盆腔孤立性纤维瘤的CT诊断

CT diagnosis of solitary fibrous tumor of abdomen and pelvis

目的探讨腹部及盆腔孤立性纤维瘤(SFT)的CT征象,进一步提高对本病的认识。方法回顾性分析11例经手术病理证实的腹部及盆腔孤立性纤维瘤的CT表现。结果 11患者中,6例发生于腹部,5例发生于盆腔,肿瘤大小在4.6cm×4.0cm×3.0cm～10cm×14cm×21.3cm之间,9例病变呈类椭圆形,2例呈不规则形,10例病变边缘清楚,1例病变边缘不清,其中2例盆腔肿瘤带蒂。CT平扫4例呈均匀稍低密度,7例呈等低混杂密度,其中2例病变内见点状钙化影,增强扫描3例病变呈明显均匀强化,8例呈不均匀性强化,其中3例患者在中度及明显强化肿块内见散在轻度强化斑片状及纵形索条状影,5例病变在动脉期呈轻度-明显不均匀强化,门脉期肿块实质部分进一步强化,内见线条状、斑片状及片状无强化区,肿块内及周围见增粗、迂曲血管影。结论腹部及盆腔孤立性纤维瘤的CT表现有一定的特征性,但最后确诊仍需结合病理学及免疫组织化学。

Objective To explore the CT signs of solitary fibrous tumor （SFT） of abdomen and pelvis so as to further improve the understanding of this disease. Methods The CT performance of 11 cases of SFT of abdomen and pelvis confirmed by operation and pathology was retrospectively analysed in this work. Results Of these 11 patients, 6 occurred in abdomen and 5 cases in pelvis. Tumor volume was about 4.6 cm×4 cm×3.0 cm～10 cm×14 cm×21.3 cm. As for the morphology, 9 patients appeared as oval, 2 presented with irregular shape, 10 with clear border, 1 with unclear edge, 2 pelvic tumors with pedicle. 4 cases showed slight homogeneous low density on CT scan, 7 cases showed low mixed density, of which 2 cases presented with punctate calcification within the lesion, 3 cases showed homogeneous enhancement on enhanced scan, 8 cases showed heterogeneous enhancement, 3 patients with moderate and marked enhancement, in which the scattered mild enhancement patchy and longitudinal cable strip film were seen in masses, 5 cases showed mild to significant heterogeneous enhancement in the arterial phase. The substantive part was further strengthened in the portal phase, in which line shape, patchy and flaky within no enhancement area, thickening and tortuous vascular shadow were also seen. Conclusion CT manifestations of SFTumor of the abdomen and pelvis possess certain characteristics, the final diagnosis, however, still needs to combine the CT signs with pathology and immunohistochemistry.