多层螺旋CT多期增强对胸膜孤立性纤维瘤的诊断价值

The diagnostic value of MSCT multi-phase enhanced scan in solitary fibrous tumor of the pleura

目的探讨多层螺旋CT(MSCT)多期增强扫描对胸膜孤立性纤维瘤(SFPT)的诊断价值,以提高诊断准确率。方法回顾分析18例经手术或穿刺病理结果证实的SFPT患者的临床及CT资料。分析肿瘤的发生部位、大小、形态、密度、与周围组织关系及多期增强的强化特点,对其临床及影像表现进行分析总结。结果 18例病灶均为单发病灶,左侧10例,右侧8例。病灶最大径为0.8~7.5cm(中位3.2cm),>5.0cm者6例,<3.0cm者7例。18例病灶均行CT平扫和多期增强扫描,CT平扫稍低密度者5例,等密度6例,混杂密度7例(钙化3例,坏死4例)。增强扫描均匀强化者8个;"地图样"不均匀强化者10个;12例动脉期未见明显强化,静脉期及延迟期呈轻中度强化;4例动脉期呈轻中度不均匀强化,静脉及延迟期强化程度更高;2例动脉期呈中度不均匀强化,静脉期及延迟期强化程度稍减低。结论 SFTP在CT上具有一定特征性表现,多期增强扫描能反应病变强化特点,对于术前诊断具有重要的价值。

Objective To investigate the value of multi-slice spiral CT（ MSCT） enhanced scan in the diagnosis of solitary fi-brous tumor of pleura （ SFPT） so as to improve the diagnostic accuracy. Methods We retrospectively analysed of clinical and CT data of 18 cases who were confirmed SFPT by operation or biopsy from 2013~2016. We analysed of tumor location, size, shape, density, relationship with surrounding tissue and multi phase enhanced characteristics, and summarized the clinical and imaging findings. Results 18 cases were single lesions, 10 cases occurred on the left side, 8 cases on the right. The maximum diameter of the lesions was 0. 8~7. 5 cm （median 3. 2 cm）. 6 cases were larger than 5. 0 cm, 7 cases were less than 3. 0 cm. 18 lesions were all performed on multi phase enhanced CT scan. The 5 cases were mild hypoattenuation, 6 cases presented with iso-density, and other 7 cases showed mixed attenuation （3 cases with calcification and 4 cases with necrosis）. 8 cases were per-formed homogeneous enhancement;while 10 cases showed＂map like＂ uneven enhancement. 12 cases showed no enhancement in arterial phase, then showed mild to moderate enhancement in venous phase and delayed phase;4 cases showed mild to moderate inhomogeneous enhancement in arterial phase, and enhanced higher degree in venous and delayed phase;2 cases showed moder-ate heterogeneous enhancement in arterial phase, and enhancement decreased slightly in venous and delayed phase. Conclusion SFTP has some special characteristics on CT, and multi phase enhanced scan can reflect the feature of lesion enhancement and has important value for preoperative diagnosis.