脊柱孤立性纤维瘤/血管外皮细胞瘤的影像分级诊断及预后分析

Solitary Fibrous Tumor/Hemangiopericytoma of the Spine:Imaging Grading Diagnosis and Prognosis

目的:探讨脊柱孤立性纤维瘤(SFT)/血管外皮细胞瘤(HPC)的不同病理分级的影像学特征及预后。方法:回顾性分析经病理证实的23例脊柱SFT/HPC患者的资料。分析不同病理分级肿瘤间的临床、影像、Ki-67和预后差异性。结果:WHOⅡ级14例(60.9%),WHOⅠ级和Ⅲ级分别为3例(13.0%)和6例(26.1%)。WHOⅢ级的Ki-67表达水平明显高于WHOⅡ级(P<0.05)。WHOⅠ级T2WI均呈低信号,WHOⅡ级和Ⅲ级T2WI呈等或稍高信号。WHOⅡ级与Ⅲ级间的强化方式和溶骨性骨质破坏存在统计学意义(P<0.05);两者间的年龄、性别、位置、MR信号、强化程度、压迫性骨质吸收、脊膜尾征和纵/横比无统计学意义(P>0.05)。WHOⅡ级和Ⅲ级较WHOⅠ级更容易出现局部复发或转移(P<0.05)。结论:脊柱WHOⅢ级SFT/HPC的肿瘤细胞增殖更旺盛。不同病理分级间的MR表现具有一定的特征性。WHOⅡ级和Ⅲ级更容易出现局部复发或转移。

Purpose:To explore the imaging features and prognosis of different pathological grades of spinal solitary fibrous tumor(SFT)/hemangiopericytoma(HPC).Methods:The clinical data,imaging,Ki-67 expression level and prognostic results among different pathological grades of 23 patients with spinal SFT/HPC confirmed by pathology results were retrospectively analyzed.Results:Of the 23 cases,14(60.9%)were WHO gradeⅡ,3(13.0%)and 6(26.1%)were WHO gradeⅠand gradeⅢ,respectively.The Ki-67 expression level of WHO gradeⅢwas significantly higher than that of WHO gradeⅡ(P<0.05).The lesions appeared hypointense on T2 WI in all WHO gradeⅠ,and appeared isointense or mildly hyperintense on T2 WI in both WHO gradeⅡand gradeⅢ.The enhancement pattern and osteolytic bone destruction were significantly different between WHO gradeⅡand gradeⅢtumors(P<0.05),but there was no significant difference of age,gender,location,MR signal,degree of enhancement,compressive bone resorption,meningeal tail sign and longitudinal/horizontal ratio between them(P>0.05).WHO gradeⅡand gradeⅢwere more likely to have local recurrence or metastasis than WHO grade I(P<0.05).Conclusion:The tumor cells of WHO gradeⅢspinal SFT/HPC proliferate more vigorously.MR manifestations between different pathological grades have certain characteristics.WHO gradeⅡand gradeⅢtumors are more prone to local recurrence or metastasis.