胸膜外孤立性纤维性肿瘤MSCT与MRI征象

MSCT and MRI Findings of Extra-pleural Solitary Fibrous Tumors

目的:探讨胸膜外孤立性纤维性肿瘤(ESFT)的MSCT与MRI影像诊断。方法:分析12例ESFT的CT与MRI资料,5例行CT平扫和增强,4例MR平扫和增强,1例行CT平扫及MR平扫和增强,2例MR平扫。结果:腹盆部5例,头面部5例,四肢2例;单发11例,双发1例,共13处病灶;瘤体呈类圆形5例,不规则形8例;边缘清楚6例,边缘呈浸润或模糊状7例;实性10例,囊实性3例。CT平扫呈均匀及混杂密度各3例,5例增强后动脉期均匀强化2例,不均匀强化3例,强化呈斑片状和线条状,静脉期进行性增强或减低,3例见钙化及坏死。MR平扫肿瘤实质部分4例T1WI等信号,T2WI等及稍高信号;4例T1WI等、低信号,T2WI等、低或稍高混杂信号;增强后肿瘤实质明显强化。结论:ESFT影像学有一定特征,典型征象为孤立的明显进行性强化的软组织肿瘤,当肿瘤实质区T1WI或T2WI出现等低信号且增强明显强化时应考虑SFT诊断可能。

Purpose： To investigate the CT and MR imaging features of extra-pleural solitary fibrous tumors （ESFT）. Methods： CT and MRI findings of 12 cases with ESFT were analyzed retrospectively. Of all the cases, 5 cases were undergone plain and enhancement CT scans, both plain and enhancement MRI scans were performed in 4 cases, 1 case was performed plain CT and MRI scans and enhancement MRI scans, 2 cases were undergone plain MRI scans. Results： OLocation and shape： There were 5 cases located in the abdominal-pelvic cavity, 5 cases in head and face, 2 cases in limbs. One case had 2 tumors and 11 cases had only one, the tumors were showed as quasi-circular （5 cases） or irregular （8 cases） shape, clear- cut margin （6 cases） and infiltrating appearance （7 cases）. Most of the tumors were solid. ~Density and intensity： On CT imaging, 6 tumors showed evenly density （3 cases） or unevenly density （3 cases）. Two cases showed homogeneous enhancement and 3 showed heterogeneous enhancement in arterial phase, the solid component in lesion showed progressive patchy or linear enhancement or lower density in venous phase. Three patients presented tumor with necrosis and calcification. Four cases showed iso-intensity on T1WI and iso-intensity or hyper-intensity on T2WI, 4 cases showed iso-intensity or hypo-intensity on T1WI, mixed intensity on T2WI. The tumors were obviousl3; enhanced in contrasted imaging. Conclusion： MRI/CT findings of ESFT have certain characteristic features. A solitary soft tissue mass with obvious progressive enhancement, iso-intensity or hypo-intensity on T1WI or T2WI and marked enhancement of solid component should be suggested ESFT.