孤立性纤维瘤的CT表现

目的探讨孤立性纤维瘤（SFT）的CT征象，提高对SFT影像表现的认识及术前诊断率。方法回顾性分析经临床及病理检查证实的314例SFT，所有患者均行CT增强扫描。结果31例（31枚）SFT病灶中，最大径范围1．4～17．0cm，以类圆形、边界清楚为主；CT平扫以等密度为主，内可见钙化及囊变；增强扫描头颈部、胸部及盆腹部病灶明显强化、中度强化及轻度强化例数分别为（5：5：9）、（0：3：0）、（0：7：2）；头颈部、胸部及盆腹部病灶可见瘤周血管例数分别为3、1、5枚。病理及免疫组化证实恶性SFT3枚，良、恶性中位最大径分别为5．2cm、12．8cm；盆腹部病灶2枚，边界欠清、见钙化及瘤周血管病灶各2枚，3杖均可见低密度区。结论SFT可发生于任何部位．一般影像学表现为边界清楚、孤立性、密度不均匀的类圆形软组织肿块，头颈部及盆腹部SFT大部分表现为明显强化，而胸部SFT强化各种各样。当病灶直径〉12cm、边界欠清，伴囊变、钙化及瘤周血管时要警惕恶性可能。

Objective To investigate the imaging findings of solitary fibrous tumor （ SFT ） and improve the understanding and preoperative diagnostic rate of SFT. Methods 31 cases of SFT were analyzed retrospectively and all these lesions were confirmed though clinical and histopathologic, and all the patients were examined CT dynamic contrast scanning. Results In the 31 cases of 31 lesions, the maximum diameter range of the 31 lesions were 14.0-17.0cm, most of them were round and clear. The plain CT scan appeared as iso-density soft tissue mass mostly, there were calcification and low density area in the lesions. The number of the obvious enhancement, moderate enhancement and mild enhancement of head and neck, chest and pelvic abdomen were （5 ： 5 ： 9） 、 （0 ： 3 ： 0） 、 （0 ： 7 ： 2） respectively, the number of peripheral vascular of head and neck, chest and pelvic abdomen were 3, 1, 5 respectively. 3 lesions were diagnosed as malignant SFT by the immune-histochemical, the benign and malignant SFTs＇ median maximum diameter were 5.2cm, 12.8cm respectively, 2 lesions were unclear, there were calcification and peripheral vascular in 2 lesions, all the 3 lesions had low density areas. Conclusions SFTs can be found in any sites. The general imaging findings are isolated, round, clear and hetergeneous density soft tissue mass. The enhancement of the head and neck and pelvic abdomen are obvious enhancement mostly, and enhancement of the chest is various. When the lesion diameter is 〉 12cm, the boundary is not clear, with cystic changes, calcification and peritumoral vessels, we should be vigilant against malignancy.