颅内孤立性纤维瘤的临床、病理和影像学表现  

The clinical,pathological and imaging findings of Intracranial Solitary Fibrous Tumor

作　　者：朱辉严[1] 谌力群[1] 许平[1] 谢磊[1] 

机构地区：[1]广东省农垦中心医院放射科,广东湛江524002

出　　处：《现代医用影像学》2017年第2期305-307,共3页Modern Medical Imageology

摘　　要：目的:通过探讨颅内孤立性纤维瘤(ISFT)的临床表现、病理学和影像学特征,提高对颅内孤立性纤维瘤的认识。方法:回顾性分析2009年9月至2016年6月期间在我院治疗并经病理确诊的6例颅内孤立性纤维瘤患者的临床表现、病理学资料及影像学特点。6例患者均行头颅MRI平扫及增强扫描,4例行头颅CT平扫,术后均行病理免疫组化检查。结果:临床表现为头痛5例,头痛伴视力下降2例,1例为体检发现,无自觉症状。右侧小脑天幕2例,右侧枕部1例,右侧顶部1例,左侧额部1例,右侧颞部1例;6例病灶均表现为实性肿物,最大长径约2.3-6.7cm,平均约4.1cm。4例行CT检查平扫病灶呈等或稍高密度。6例行MRI检查病灶在T1WI序列上呈等信号2例,等高混杂信号4例,在T2WI序列呈等、低混杂信号4例,均匀性等信号2例,2例病灶相邻脑实质内伴有水肿,增强扫描6例病灶均有不同程度强化,4例T2WI序列低信号区明显强化,2例病灶伴有"脑膜尾征";2例病灶内及边缘可见流空血管。免疫组化检查结果显示:Vimentin、CD99均为阳性;CD34(+)3例;S100(-)5例。结论:颅内孤立性纤维的临床表现主要为肿瘤占位症状和颅内高压,颅内孤立性纤维瘤CT和MRI表现有一定的特征性,确诊仍需结合病理免疫组织学检查。Purpose：To investigate intracranial solitary fibrous tumor（ISFT） clinical manifestations,pathology and imaging features,to raise awareness of intracranial solitary fibrous tumor.Materials and Methods：A retrospective analysis from September 2009 to June 2016 in our hospital and the treatment of the clinical manifestations of pathologically confirmed six cases of intracranial solitary fibrous tumor patients,pathological data and imaging features.6 patients underwent brain MRI scan and enhanced scan,4 routine head CT scan,postoperative pathological immunohistochemical examination.Results：The clinical manifestations of 5 cases of headache,headache associated with decreased vision in 2 cases,1 case of physical examination found no symptoms.Right cerebellum sky two cases right occipital one case,top right one case,one case of the left frontal,right temporal region（1）; 6 cases of the lesion showed a solid mass,the maximum long diameter of about 2.3-6.7cm,an average of about 4.1cm.4 routine CT scan examination lesions showed equal or slightly higher density.On unenhanced MRI,the lesions such as signal on T1 WI sequence in 2 cases,4 cases such as mixed signal,other signals in T2WI sequences showed equal,lower hybrid signal in 4 cases,uniformity and other signals in 2 cases,2 cases of adjacent brain parenchyma lesions associated with edema,enhanced scan six cases lesions varying degree of enhancement in 4 cases T2WI sequence significantly enhanced low signal area,2 lesions associated with＂dural tail sign＂; 2 lesions were visible edge and vascular flow void.Immunohistochemical examination showed：Vimentin,CD99 was positive; CD34（＋） 3 cases; S100（-） 5 cases.Conclusion：The clinical manifestations of intracranial solitary fibrous tumor occupying the main symptoms and intracranial hypertension,intracranial solitary fibrous tumor CT and MRI findings have certain characteristics,combined with the pathological diagnosis remains immune histological examination.

关 键 词：孤立性纤维瘤 免疫组化 磁共振 脑膜尾征 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.44[医药卫生—诊断学] R739.41[医药卫生—临床医学]