中枢神经系统孤立性纤维瘤的影像学表现

Imaging findings of solitary fibrous tumor in central nervous system

目的探讨中枢神经系统孤立性纤维瘤（SFT）的影像学特征。方法回顾性分析9例经手术及病理证实的SFT影像学资料，并与病理学结果进行对照分析。结果①9例SFT均为单发病灶，发生于幕上者5例，幕下1例，枕部中线跨天幕1例、伴颈椎管种植转移，颈椎管、右侧脑室体部各1例。肿瘤边界清楚，椭圆形或类圆形6例，不规则形3例；2例可见分叶征，病灶最大径15．26～78．13mm。②4例CT平扫为略高密度，2例密度均匀，2例不均匀，1例瘤内伴灶性坏死，1例合并出血。③与脑实质对比，6例T1wI呈等信号为主的不均匀信号，2例呈均匀等信号；6例T2WI为低、等（或略高）混杂信号，2例为均匀等或略高信号。④增强扫描病变不均匀强化5例，均匀强化2例；3例可见“脑膜尾征”；2例见血管流空。⑤镜下显示肿瘤由疏密不均的梭性细胞、致密胶原纤维以及大量薄壁血管组成。结论中枢神经系统SFT的MRI表现具有一定特征性，与临床病理有密切的内在联系，是诊断SFT有价值的检查方法。

Objective To observe imaging characteristics of solitary fibrous tumor （SFT） of central nervous system （CNS）. Methods Imaging data of 9 patients with SFT confirmed by surgery and pathology were analyzed retrospectively, and the results were compared with those of pathological examination. Results @All 9 cases had single SFT, among them 5 were found supratentorially, 1 around the tentorium and with cervical spinal metastasis, 1 beneath the tentorium, 1 in cervical canal and 1 case in the right ventricle. All tumors had clear boundary, 6 were oval or round, 3 were irregular shaped and 2 were lobulatedly shaped. The maximum diameter was 15.26--78.13 ram. @On plain CT, 4 tumors were slightly hyperdensity, 2 were uniform and 2 were uneven, 1 with focal necrosis and 1 with hemorrhage. @On plain TIWI, SFT in 6 cases showed inhomogeneous signals mainly present as isointensity, while in 2 cases were evenly equisigna[. On plain T2WI, SFT in 6 cases showed as low and isointensity （or slightly higher）. @On enhanced MRI, markedly inhomoge- neous and homogeneous enhancement of SFT were noticed in 5 and 2 cases, respectively, and ＂dural tail＂ sign was found in 3 cases, while multiple circuitous vessels were found in 2 cases. @Histologically, SFTs were composed of juxtaposed hy- per-and hypo-cellular spindle cells, as well as dense collagenous stroma and numerous thin-walled blood vessels with config- uration. Conclusion MRI manifestations of SFT in CNS have some characteristics, which are closely correlated with clini- cal pathological findings.