脊柱孤立性纤维瘤的影像学诊断

Radiographic Diagnosis of Spinal Solitary Fibrous Tumor

目的探讨脊柱孤立性纤维瘤(SFT)的CT和MRI表现,提高影像诊断的准确性。资料与方法回顾性分析经病理证实的8例脊柱SFT的CT和MRI征象。8例患者均行CT和MRI扫描,分析病变位置、形态、大小、密度/信号、边界、病变内部情况、邻近骨质破坏情况及强化特点等。结果 8例患者经病理证实良性4例,恶性4例。6例表现为跨椎间孔生长的哑铃形软组织肿块,1例位于椎管外呈分叶状,1例位于椎管内髓外硬膜下呈长梭形;6例出现邻近骨质膨胀性或溶骨性破坏,1例呈压迫性骨缺损,1例无明显骨质破坏。CT扫描显示肿瘤呈等/混杂密度。MRI扫描T1WI呈等/低信号;6例T2WI呈等/稍高信号,2例呈混杂信号。所有病灶增强扫描均呈明显不均匀强化。结论脊柱SFT紧贴或环绕硬膜生长呈分叶状或哑铃形,MRI信号特征明显,T1WI多呈等/低信号,T2WI多呈稍高/等信号,常伴骨质破坏。

Purpose To explore the CT and MRI manifestations of spinal solitary fibrous tumor（SFT） to improve the accuracy of imaging diagnosis. Materials and Methods CT and MRI manifestations of eight pathologically confirmed SFT were retrospectively analyzed. CT and MRI scan were performed in 8 cases. The location, shape, size, density/signal, margin, condition of the internal lesion, adjacent bone destruction and reinforcement characteristic were also analyzed. Results Of the 8 patients, 4 cases were pathologically confirmed benign and the other 4 cases were malignant. 6 cases showed trans-intervertebral foramen dumbbell shaped soft tissue masses, 1 case showed lobulated soft tissue mass lying outside the invertebrate canal and 1 case showed long fusiform lying in intradural extramedullary of spinal canal. 6 cases had adjacent bone swelling or osteolytic destruction, 1 case had compressive bone defect, and 1 cases showed no obvious bone destruction. The tumor showed an equal/mixed density on CT scan. T1 WI equal/low signal was seen in MRI scan. Equal/slightly higher T2 WI signals were seen in 6 cases and mixed signals in 2 cases. All patients undergoing enhanced scan showed obviously inhomogeneous enhancement. Conclusion Spinal solitary fibrous tumors are lobulated or dumbbell shaped and growth clinging to or surround the dura mater. The feature of MRI signal is evident that T1 WI is mostly equal/low signal and T2 WI is usually slightly higher/equal signal, often accompanied by bone destruction.