颅内孤立性纤维瘤的CT和MR表现  

Intracranial Solitary Fibrous Tumors: CT and MR Findings

作　　者：程增辉[1] 戴飞[1] 栾丽娟[2] 王佩芬[3] 武刚[1] 

机构地区：[1]复旦大学附属中山医院青浦分院放射科上海市公园东路1158号,上海201700 [2]复旦大学附属中山医院病理科上海市公园东路1158号,上海201700 [3]复旦大学附属中山医院放射科上海市公园东路1158号,上海201700

出　　处：《中国医学计算机成像杂志》2015年第3期215-218,共4页Chinese Computed Medical Imaging

摘　　要：目的：探讨颅内孤立性纤维瘤（ISFT）的CT和MR表现特征,提高对其影像表现的认识。方法：回顾性分析经手术病理证实的4例ISFT临床及影像学资料（位置、形态、大小、密度或信号强度、强化方式及程度、邻近颅骨改变）。结果：ISFT最常见症状是头痛头晕（3/4）,4个病灶皆起源于硬脑膜,其中幕上2个,幕下1个,跨天幕生长1个,分叶状3个,类圆形1个,最大径3~8.5cm,平均5.6cm,CT平扫呈不均匀稍高及高密度,无明显钙化;MR T1WI等稍高信号,T2WI混杂等高信号,增强后明显不均匀强化（3/4）,1例出现典型＂阴阳征＂,2例出现＂脑膜尾征＂,邻近颅骨侵蚀性改变2例。结论：当颅内脑外肿瘤T2WI信号不均匀,增强后明显不均匀强化,尤其出现典型＂阴阳征＂及邻近颅骨侵蚀性改变时应考虑到ISFT的可能性。Purpose： To study the CT and MR features of intracranial solitary fibrous tumors （ISFT）. Methods： Clinical data and neuroimaging features of 4 consecutive histopathologically proven ISFT cases were retrospectively analyzed. Location, shape, size, density, signal intensity, gadolinium uptake and change of skull adjacent to the tumor were studied at CT and MR. Data collected from Diffusion-weighted imaging （4 patients） and DSA （1 patient） were also analyzed. Results： The most common symptoms of ISFT were headache and dizziness （3/4）. All these 4 tumors arose from intracranial meninges, with 2 from supratentorial, 1 from infratentorial and 1 from supratentorial and infratentorial. Three tumors presented with multi-lobular shape and 1 with round like shape. Tumor size ranged from 3 to 8.5cm （mean： 5.6cm）. Heterogeneous hyper-dense and no calcifications were seen on plain CT scan, while iso/hyper-signal was seen on TtWI and heterogeneous hyper-signal on T2WI. Most tumors （3/4） were strongly enhanced after gadolinium administration with 1 showing typical ＂Yinyang＂ sign and 2 showing ＂dural tail＂ sign. Skull erosion adjacent to the tumor was seen in 2 patients. Conclusion： ISFT should be considered in cases of extra-axial, with heterogeneous signal on T2WI, strongly heterogeneous enhancement after gadolinium administration, especially with typical ＂Yinyang＂ sign and skull erosion adjacent to the tumor.

关 键 词：脑 孤立性纤维瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]