颅内孤立性纤维瘤的MRI特征与病理分析  

MRI features and pathological analysis of intracranial solitary fibrous tumor

作　　者：徐万里[1] 郑屹峰[1] 方炜[1] 

机构地区：[1]湖州市中心医院放射科,浙江湖州313000

出　　处：《实用放射学杂志》2018年第1期19-22,共4页Journal of Practical Radiology

摘　　要：目的 分析颅内孤立性纤维瘤（SFT）的MRI影像表现及病理资料,以提高对该病的认识及影像诊断水平.方法 回顾性分析经手术病理证实的6例颅内SFT患者的MRI影像及临床病理资料.结果 6例肿瘤中4例呈不规则分叶状,2例呈椭圆形,病灶边界清楚,大小3.0~8.6 cm,平均6.3 cm.肿瘤均位于幕上,右侧额顶部1例,额部跨中线2例,枕部跨中线2例,跨小脑幕生长1例.6例肿瘤实质部分在T1WI及T2WI上均呈等、稍低信号,其中4例肿瘤内T2WI上见高低混杂信号,形成＂阴阳＂征.4例肿瘤周围T2WI上可见明显水肿,5例肿瘤内可见迂曲流空血管影,FLAIR均呈高低混杂信号,DWI呈稍高信号.MRI增强后肿瘤实质部分呈明显不均匀强化,其中3例肿瘤T2WI低信号区明显均匀强化,囊变坏死区及瘤周水肿未见强化,3例肿瘤邻近脑膜强化形成＂脑膜尾征＂.病理上瘤细胞呈梭形、束状、编织状分布,胶原纤维丰富.免疫组化可见CD34（＋）、CD99（＋）、Vim（＋）.1例呈恶性,1例潜在恶性.结论 颅内SFT的MRI表现虽具有一定特征性,定性较困难.MRI对显示肿瘤部位、形态、范围及其与周围组织的关系具有明显优势,对临床手术方案及术后肿瘤是否有残留、复发具有重要的临床应用价值.Objective To analyze MRI findings and pathological data of intracranial solitary fibroma tumor（SFT）to improve the understanding of this disease and the level of imaging diagnosis.Methods MRI images and clinical pathological data of 6 patients with intracranial SFT confirmed by surgery and pathology were analyzed retrospectively.Results All tumors were located in the supratentorium,in which 4 cases were irregularly lobulated,2 cases were oval.All lesions were clear boundaries,and size 3.0-8.6 cm （an average of 6.3 cm）.The tumor was located in the right fronto-perietral area in 1 case,cross of the frontal midline in 2 cases,cross of the occipital midline in 2 cases and cross of the cerebellum in 1 case.On T1WI,6 cases of tumor parenchyma showed slight low signal.On T2WI,4 cases of tumors showed mixed signal with the＂Yin and Yang＂sign,and peritumoral edema was showed in 4 cases, tortuous flow void blood vessels were showed in 5 cases.On FLAIR,mixed signal was showed.On DWI,slightly higher signal was showed.On MRI enhanced study,tumor parenchyma was significantly increased,in which 3 cases of T2WI low signal areas were significantly enhanced,cystic necrosis and edema were not enhanced,and 3 cases showed＂dural tail sign＂.On pathological study, tumor cells were spindle-shaped,bundle and braided distribution,rich in collagen fibers.Immunohistochemistry showed CD34（＋）, CD99（＋）,Vim（＋）.1 case was malignant,and 1 case was potentially malignant.Conclusion MRI features of intracranial SFT have certain characteristics,it is difficult to be characterized qualitatively.MRI has obvious advantages in the relationship of tumor location, shape,range and its relationship with surrounding tissue.It has important clinical application value for the clinical operation plan and the residual or recurrence of tumor after operation.

关 键 词：孤立性纤维瘤 脑肿瘤 磁共振成像 病理学 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]