CT和MRI在胸腹部孤立性纤维性肿瘤诊断中的应用  

The Diagnostic Value of CT and MRI for Chest and Abdominal Solitary Fibrous Tumors

作　　者：汪林[1] 姜增誉[2] 

机构地区：[1]福建医科大学附属泉州第一医院影像科,362000 [2]山西医科大学第一医院放射科,030001

出　　处：《临床放射学杂志》2017年第12期1771-1774,共4页Journal of Clinical Radiology

摘　　要：目的分析CT和MRI对于孤立性纤维性肿瘤的诊断价值。方法回顾性分析2006年3月至2015年4月收治经病理证实的50例胸腹部孤立性纤维性肿瘤CT和MRI检查资料。结果胸腹部孤立性纤维性肿瘤发生于胸部27例,腹部23例。肿瘤直径为1.4~23.1 cm,平均为(8.8±6.7)cm。体积小者多呈圆形或椭圆形,而体积较大者多呈不规则状或者分叶状。肿瘤的边界清楚者33例,边界不清者17例。27例CT表现:13例CT平扫中有6例密度不均匀,内含低密度区,7例密度均匀。14例行CT增强扫描中均呈现不均匀的强化,其实性成分动脉期见迂曲血管影,静脉期11例可见渐进性强化后强化趋于均匀,3例可见持续性强化。23例MRI表现:12例MRI平扫中,肿瘤在T1WI上呈等信号,在T2WI上3例呈低信号,2例为等信号,5例呈高信号,2例为混杂信号;11例增强扫描中均呈现不均匀强化,6例呈"地图"样强化,3例肿瘤内见强化的迂曲血管,2例于周边见强化的迂曲血管。结论 CT和MRI对于胸腹部孤立性纤维性肿瘤均有良好的诊断价值,有助于在术前对胸腹部孤立性纤维性肿瘤进行有效判断。Objective To analyze the diagnostic value of CT and MRI for solitary fibrous tumors. Methods A retrospective analysis was performed from March 2006 to April 2015,were 50 cases of solitary fibrous tumor of the chest and abdomen of patients were evaluated for diagnosis,and the results of CT MRI CT combined with MRI compared on solitary fibrous tumor of the chest and abdomen. Results In all thoracic and abdominal solitary fibrous tumors,in 27 patients tumors occurred in chest and in 23 patients the tumors occurred in abdomen. CT findings of 27 cases： 13 cases of CT scan,six cases were uneven density,containing low-density areas,seven cases of uniform density. Enhanced CT in all 14 cases showed uneven enhancement,we could see its tortuous vascular shadow in solid component in arterial,at venous phase,11 cases showed progressive enhancement and tends to be enhanced all the time the results of CT MRI CT combined with MRI,three cases showed persistent enhancement visible. 23 cases of MRI findings： 12 cases of MRI scan,the tumor on T1 WI showed equal signal; on T2 WI 3 showed low signal,two cases had equal signals,5 cases showed high signal,2 cases showed mixed signals; 10 cases showed enhancement and heterogeneous enhancement,six cases were＂Maps＂-like enhancement,2 cases showed reinforced tortuous blood vessels within the tumor,2 cases showed enhancing vessels in the surrounding. 27 cases diagnosed by CT as thoracic and abdominal solitary fibrous tumors,while 24 cases of them confirmed by immunohistochemistry as thoracic and abdominal solitary fibrous tumor,the accuracy rate was 88. 89%,22 cases diagnosed by MRI as thoracic and abdominal solitary fibrous tumors,while 21 patients were confirmed by immunohistochemistry as thoracic and abdominal solitary fibrous tumor patients,the accuracy rate was 95. 45%（ P〉0. 05）. Conclusion CT and MRI has a good diagnostic value for chest and abdominal solitary fibrous tumors,it can help diagnose chest and abdominal solitary fibrous tumor in preoperative.

关 键 词：孤立性纤维性肿瘤 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] R730.44[医药卫生—诊断学]