孤立性纤维瘤的影像表现及临床病理特征

Imaging and clinicopathologic features of solitary fibrous tumor

目的:分析孤立性纤维瘤(SFT)的影像表现及临床病理特征,提高对SFT的诊断水平。方法:回顾性分析58例经病理证实的SFT患者的临床、病理及影像资料。58例SFT中47例行CT扫描,23例行MRI扫描,12例同时行CT、MRI检查。结果:58例均为单发肿块,最大径1.1~19.4 cm,其中病灶位于颅内14例,颅外3例,肺内9例,胸腔10例,腹盆部14例,椎管内3例,膈肌、胸壁、胫骨、肱骨及大腿各1例。肿瘤表现为类圆形28例,不规则或分叶状30例。肿块边界清楚46例,边界不清12例。CT上病灶多呈等或稍低密度。T_(1)WI上病灶呈等或等低信号,T_(2)WI呈稍高或高低混杂信号,DWI呈等或等低混杂信号。CT或MRI增强扫描17例呈均匀明显或轻度强化,41例呈不均匀明显或中度强化,其中29例呈“地图样”强化;静脉期及延迟期32例持续强化。29例见迂曲血管或流空信号。结论:若CT和MRI发现边界清楚、密度或信号不均的孤立性肿块,增强扫描呈不均匀或“地图样”持续性强化,且多发迂曲血管或流空信号时,应考虑SFT可能。

Objective:To explore the imaging and clinicopathological features of systemic solitary fibrous tumor(SFT),and to improve the diagnosis efficacy of SFT.Methods:The clinical,pathological,and imaging data of 58 patients with pathologically confirmed SFT were retrospectively analyzed.Among them,47 patients underwent CT scanning,23 patients underwent MRI scanning,and 12 patients underwent both examinations.Results:All lesions were solitary with size of 1.1~19.4cm,among which 14 located in the intracalvarium,3 in the extracranial,9 in the lung,10 in the thoracic cavity,14 in the abdominopelvic cavity,3 in the intraspinal,and 1 each in the diaphragm,chest wall,tibia,humerus,and thigh.The shape of the tumor was round in 28 cases and lobulated in 30 cases.The boundary of mass was well-demarcated in 46 cases and ill-defined in 12 cases.On CT,the majority of tumors demonstrated slightly hypo-or iso-density.On MRI,the tumors mostly showed isointense or heterogeneously iso-hypointense signal on T_(1)WI,slightly high or mixed high-low signal on T_(2)WI,hypointense or heterogeneously iso-hypointense signal on DWI.On the contrast-enhanced CT or MRI images,17 cases demonstrated homogeneously significant or mild enhancement and 41 cases were heterogeneously significant or moderate enhancement,among which 29 cases showed map-like enhancement.Continuous enhancement was observed in 32 cases during venous phase or delayed phase.Multiple tortuous vessels or blood vessel flow void phenomena were found in 29 cases.Conclusions:SFT tend to show a heterogeneous mass with well-demarcated border,map-like enhancement or heterogeneously persistent enhancement and multiple tortuous vessels or blood vessel flow void phenomena.