胸膜外孤立性纤维性肿瘤的影像学表现及病理对照分析  

Comparison between imaging manifestations and pathological findings of extra-pleural soliary fibrous tumor

作　　者：曲方园 刘颖[1] 黄金超 叶兆祥[1] QU Fangyuan;LIU Ying;HUANG Jinchao;YE Zhaoxiang(Tianjin Medical University Cancer Institule and Hospital,Tianjin 300060,China)

机构地区：[1]天津医科大学肿瘤医院放射科,天津300060

出　　处：《实用放射学杂志》2020年第1期38-41,86,共5页Journal of Practical Radiology

摘　　要：目的探讨胸膜外孤立性纤维性肿瘤(ESFT)的CT与MRI表现.方法回顾性分析41例经病理证实的ESFT患者的影像学资料,从病灶部位、大小、形态、边界、密度/信号、强化方式等方面总结其影像表现特征.结果41例ESFT均为单发病灶.15例形态不规则,其余呈类圆形或类椭圆形.28例边界清楚;13例边界不清,侵犯周围组织或与周围组织粘连.41例ESFT中,钙化及出血少见,18例有囊变、坏死;多数病例CT增强检查后呈明显或中度不均匀强化(18/27,66.7%);6例MRI增强检查后表现为地图样改变及延迟强化,呈"快进慢出"的强化方式.免疫组化结果Vimentin、CD99、CD34阳性率90%以上,STAT6阳性率78.6%,Bcl-2阳性率81.5%.结论ESFT的影像学表现有一定特点,单发、边界清楚、平扫呈不均匀密度/信号、强化方式呈地图样"快进慢出"有诊断价值.根据病理对照分析总结病变的影像特征,有助于提高影像诊断准确性.Objective To describe CT and MRI manifestations of extra pleural solitary fibrous tumor(ESFT).Methods A total of 41 patients with pathologically confirmed ESFT were included in this study.Imaging manifestations including lesions location,size,shape,boundary,density/signal intensity,enhancement pattern were analyzed retrospectively.Results All 41 cases were single isolated.15 demonstrated as irregular shape,while the others were round or oval.28 cases showed well-defined margin,the other 13 were il-defined,invading or adhering to the surrounding tissue.Among 41 cases,caleification and hemorrhage were observed occasionally,cystic degeneration and necrosis was seen in 18 cases.On contrast-enhanced CT scans,significant or moderate heterogeneous enhancement was observed in the most cases(18/27,66.7%).On contrast-enhanced MRI,6 cases demonstrated map-like changes with a"rapid wash in and slow wash out"enhancement pattern.Im munohistochemical staining showed that Vimentin,CD99 and CD34 positive rates were over 90%,and 78.6%for STAT6 and 81.5%for Bcl-2.Conclusion The CT and MRI manifestations of ESFT have certain characteristic features,signs such as single isolated,well-defined,heterogeneous masses with"rapid wash in and slow wash out"enhancement pattern may show important value on diagnosis.Comparative analysis between pathology and imaging will be helpful to improve the diagnostic accuracy.

关 键 词：胸膜外孤立性纤维性肿瘤 计算机体层成像 磁共振成像 

分 类 号：R730.262[医药卫生—肿瘤] R814.42[医药卫生—临床医学]