胸膜外孤立性纤维瘤影像学征象及鉴别诊断  

Extra-pleural solitrary fibrous tumor: imaging diagnosis and differential diagnosis

作　　者：沈雪娇[1] 陈菲[1] 马丽[1] 孙鹏飞[1] 

机构地区：[1]兰州大学第二医院放疗科,甘肃兰州730030

出　　处：《兰州大学学报（医学版）》2016年第6期63-68,共6页Journal of Lanzhou University（Medical Sciences）

基　　金：甘肃省卫生行业科研计划管理项目(GWGL201336)

摘　　要：目的探讨胸膜外孤立性纤维瘤(ESFT)影像学征象,提高其诊断水平。方法回顾性分析经病理检查证实的14例ESFT的CT、MR征象,包括肿瘤部位、形态、内部结构及邻近改变。结果肿瘤部位:颅内、鼻腔、腹腔各2例,颈部、肝脏、盆腔、膀胱、臀部、腘窝、胸壁及右上臂肌间隙各1例。肿瘤形态:类圆形11例;不规则形3例,其中2例为恶性,肿瘤边缘不光整,均为鼻腔起源。肿瘤内部结构:实质性肿块13例,伴单发或多发小囊变区者4例,出血者1例,CT检查的8例中2例见钙化;囊实性肿块1例,起源于盆腔。MR T1WI实性部分呈稍低或等信号,T2WI呈不均匀稍高信号。肿瘤强化表现:实性部分呈轻度至中度或明显"快进慢出"型强化。结论 ESFT的发病部位、形态及内部结构特征具有一定的特征性,综合评价有助于提高其诊断准确率。Objective To explore the imaging findings of extrapleural solitary fibrous tumor （ESFT）, thereby enhangcing the understanding of the imaging manifestation. Methods The CT and MR features of 14 cases with pathologically-proved ESFT were retrospectively analyzed. The location, shape, inere structure of tu- mors and the changes of neighboring structures were recorded and the results were analyzed. Results There were two cases in the encephalic, nasal cavity, and the abdominal respectively, one case in the neck, the wall of the chest, the liver, the pelvis cavity, the bladder, the buttocks, the popliteal and the right upper arm muscle gap respectively; tumor morphology： round or oval masses in eleven patients, irregular-shaped lesions in three cases, of which two were malignant; two cases with owed clear boundary, both nasal cavity origin; Inner struc- ture： thirteen cases of solid masses, with single or multiple small cystic areas in four cases, hemorrhage in one case, patchy calcification was associated with two cases confimed by CT examination; one case of cystic-solid mass, from the pelvis cavity. MR showed iso-or hypo-intense singal on T1WI and slightly hyperintense singal on T2WI. The solid part was mild-moderate or heterogeneously strengthening and delayed reinforcement. Conclusion Extrapleural solitary fibrous tumor imaging has certain features, comprehensive evaluation of ra- diographic signs help to improve diagnostic accuracy.

关 键 词：孤立性纤维瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R814.42[医药卫生—影像医学与核医学]