胸部孤立性纤维瘤的MSCT诊断分析

Analysis of multislice spiral CT findings in the diagnosis of thoracic solitary fibrous tumor

目的探讨胸部孤立性纤维瘤的多排螺旋CT(MSCT)影像表现,以提高对该疾病的认识和诊断。方法回顾性分析31例经手术、病理证实的胸部孤立性纤维瘤患者的MSCT表现及临床资料,4例行肺CT平扫,8例行肺CT一次性增强检查,19例行肺CT平扫+增强检查;结合后处理重建图像分析胸部孤立性纤维瘤的发病部位、形态、大小、密度、边缘、增强特点及与周围组织的关系。结果 31例胸部孤立性纤维瘤患者女性21例,男性10例,位于右侧胸腔16例,左侧胸腔13例,纵膈1例,肺内多发1例。27例病灶边界清晰,呈类圆形或长椭圆形,4例边界不清,呈大片状不规则形软组织密度块影,伴有胸腔积液及邻近肋骨破坏征象;增强扫描2例动脉期未见明显强化,延迟期轻度强化;11例动脉期呈中度不均匀强化,静脉期强化程度减低;14例动脉期轻中度不均匀强化,延迟期强化较动脉期更明显。31例患者良性27例,恶性4例。结论胸部孤立性纤维瘤的MSCT表现有一定的特征,大多呈边界清楚,血供丰富、呈中度以上不均匀强化的软组织密度结节或块影,MSCT可以清晰地显示病变特点,及时进行手术切除,可提高患者预后。

Objective To explore thoracic solitary fibrous tumor（ SFT） so as to improve the diagnosis of the disease. Methods CT images and clinical data of 31 cases of SFT proved surgically and pathologically were retrospectively studied. 4 cases of lung CT plain scan,8 cases of lung CT one-time enhanced examination,19 cases of lung CT scan and enhanced examination. Analysis of the location,shape,size,density,edge,enhancement characteristics of solitary fibrous tumor of the chest and the relationship with the surrounding tissue. Results 31 cases of solitary fibrous tumor of the chest 21 cases were female,10 cases were male,16 cases were in the right side,13 cases were in the left side,1 case in mediastinal,1 case of pulmonary multiple.27 cases had clear boundary,with round or oval shape. 4 cases with irregular boundary,irregular shape and soft tissue density,and pleural effusion and adjacent rib destruction. 2 cases of arterial phase was not obviously enhanced and delay phase showed slight enhancement in enhanced scan,11 cases of arterial were moderate inhomogeneous enhancement, 14 cases of arterial light moderate inhomogeneous enhancement, delayed enhancement was more obvious than in arterial phase. 27 of 31 cases were benign,4 cases were malignant.Conclusions MSCT findings of thoracic solitary fibrous tumor has certain characteristics mostly showed clear boundary,abundant blood supply,a moderate inhomogeneous enhancement of soft tissue density nodules or masses.MSCT can clearly show the lesions characteristics,timely surgical resection was performed to improve the prognosis of patients.