CT/MRI对孤立性纤维性肿瘤的诊断价值  

Solitary Fibrous Tumor:CT and MR Imaging Diagnostic Value

作　　者：余鸿鸣[1] 范海健[1] 常莹[1] 秦国初[1] 史炯[2] 麦筱莉[1] 

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,江苏南京210008 [2]南京大学医学院附属鼓楼医院病理科,江苏南京210008

出　　处：《临床放射学杂志》2016年第7期1035-1038,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目(编号:81501526);江苏省自然科学基金项目(编号:BK20150096);南京市医学科技发展基金项目(编号:QRX11176)

摘　　要：目的探讨多层螺旋CT/MRI对孤立性纤维性肿瘤（SFTs）的诊断价值。方法回顾性分析经病理及免疫组织化学证实的22例SFTs患者的MSCT/MRI影像特点,并与组织病理学结果进行对照。结果所有病例均为单发,肿瘤位于胸部6例,腹盆部12例,颅内1例,面部1例,椎管内1例,大腿1例。15例行CT检查,4例行MRI检查,3例同时行CT和MRI检查。MSCT/MRI平扫显示肿块大小、形态多变,肿块最大径1.2~25.0 cm,平均（7.6±6.9）cm;肿块呈圆形或椭圆形17例,呈分叶状2例,不规则形3例。MSCT平扫5例密度不均匀,MRI平扫3例信号混杂;16例行MSCT和/或MRI对比增强后4例均匀强化,12例不均匀强化,其中3例肿块内可见增强血管。病理学检查提示恶性SFTs 5例,良性17例。镜下显示肿瘤细胞呈梭形,排列方式多变,间质内见大量薄壁血管;免疫组织化学：Desmin（-）21例,CD34（＋）21例,Bcl 2（＋）19例,CD99（＋）9例;良性SFTs Ki-67≤5%,恶性SFTs Ki-67≥10%。结论 SFTs患者的CT/MRI表现有一定特征性,CT/MRI检查对SFTs的定位及明确肿瘤的良恶性有价值。Objective To investigate the value of multislice spiral CT and/or MR imaging in diagnosis of solitary fibrous tumors（ SFTs）. Methods We retrospectively reviewed 22 patients with immunohistopathologically proved SFTs to analyze their CT and / or MR imaging characteristics. Results Twenty-two cases were all single mass. SFTs were located in the thoracic cavity（ 6 /22）,abdominal and pelvic cavity（ 12 /22）,intracranial（ 1 /22）,facial canal（ 1 /22）,spinal canal（ 1 /22） and thigh（ 1 /22）. The average tumors size of 22 lesions was（ 7. 6 ± 6. 9） cm（ 1. 2 ~ 25. 0 cm）; Seventeen tumors were round or ovoid,two masses were lobulated,and three lesions were irregular. Five cases showed inhomogeneous density within tumors with MSCT plain scan,3 cases showed heterogeneous signal intensity on MR imaging; On CT and / or MR imaging,4 of 16 tumors were homogeneous enhancement while the residual cases（ 12 /16） were inhomogeneous enhancement,of which multiple circuitous vessels were found in 3 cases（ 3 /12）. Pathologically,5 cases of SFTs were malignant and 17 cases of lesions were benign. Histologically,SFTs were composed of hyper-and hypo-cellular spindle cells,as well as dense stroma and numerous thin-walled blood vessels; Immunohistochemical staining showed that Desmin negative was 95. 5%（ 21 /22）,as well as positive CD34 95. 5%（ 21 /22）,Bcl 2 86. 4%（ 19 /22）,CD99 40. 9%（ 9 /22）. Ki-67 positive was ≤ 5% in benign SFTs and was ≥ 10% in malignant SFTs. Conclusion CT and / or MR imaging findings of SFTs have certain characteristic features,which is helpful in the diagnosis of SFTs and in the differential diagnosis of benign and malignant SFTs.

关 键 词：孤立性纤维性肿瘤 磁共振成像 体层摄影术 X线计算机 病理学 

分 类 号：R738.6[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2