胸膜孤立性纤维瘤的MSCT影像分析  

MSCT Image Analysis of Solitary Fibroma of Pleura

作　　者：田路[1] TIAN Lu(Department of Imaging,Heze Municipal Hospital,Heze,Shandong Province,274031 China)

机构地区：[1]菏泽市立医院影像科,山东菏泽274031

出　　处：《系统医学》2020年第20期13-16,共4页Systems Medicine

摘　　要：目的观察且分析在胸膜孤立性纤维瘤影像诊断中应用多层螺旋(mul-tisliecs helieal CT,MSCT)扫描的临床价值和作用。方法该文研究对象为2016年1月—2019年12月期间收治的经手术病理证实的28例胸膜孤立性纤维瘤(solitary fibrous tumors pleura,SFTP)患者,均采取多层螺旋CT(MSCT)平扫加增强扫描,观察胸膜孤立性纤维瘤大小、位置、边界、形态、密度、强化程度及其强化方式。结果28例胸膜孤立性纤维瘤患者均为单发疾病,位于肋侧胸膜占比为57.14%,位于纵隔侧胸膜占比为28.57%,位于膈侧胸膜占比为7.14%,位于叶间胸膜占比为7.14%。其中12例患者肿瘤最大径<5 cm,4例患者肿瘤最大径处于5~10 cm之间,12例患者肿瘤最大径≥10 cm,平均肿瘤最大径即为(8.90±0.32)cm。28例胸膜孤立性纤维瘤患者经免疫组化与组织病理学得到确诊,均为单发病灶,8例病灶带蒂,其中22例患者显示良性,6例患者显示低度恶性。平扫密度不均匀与均匀对比,差异有统计学意义(χ^2=8.763,P<0.05);均匀强化与地图样强化对比,差异有统计学意义(χ^2=14.049,P<0.05);强化特点的不均匀与均匀对比,差异有统计学意义(χ^2=14.049,P<0.05);无囊变坏死对比囊变坏死,差异有统计学意义(χ^2=14.933,P<0.05);有无瘤内血管对比,差异有统计学意义(χ^2=14.933,P<0.05);低度恶性与良性对比,差异有统计学意义(χ^2=10.182,P<0.05);有无钙化对比,差异无统计学意义(χ^2=0.747,P>0.05);无胸腔积液与胸腔积液对比,差异无统计学意义(χ^2=0.415,P>0.05)。结论胸膜孤立性纤维瘤的诊断,MSCT表现具有一定的特征,病灶较小时,增强后动脉期表现为轻中度均匀强化,病灶较大时动脉期表现为不均匀强化。有时动脉期可以见到增粗、杂乱的肿瘤血管;静脉期持续渐进性强化,呈“地图样”改变,部分病灶可以出现囊变坏死,结合MPR重建,MSCT对胸膜孤立性纤维瘤诊断具有重要价值。Objective To observe and analyze the clinical value and role of multi-slice spiral(Mul-tisliecs helieal CT,MSCT)scanning in the imaging diagnosis of pleural solitary fibroma.Methods The data analysis objects were 28 cases of solitary fibrous tumorspleura(SFTP)patients who were admitted between January 2016 and December 2019 and were confirmed by surgery and pathology.All of them were treated with multi-slice spiral CT(MSCT).Plain scan plus enhanced scan to observe the size,location,boundary,shape,density,degree of enhancement and enhancement method of pleural solitary fibroma.Results The 28 patients with solitary fibroma of the pleura were all single disease.The pleura located on the costal side accounted for 57.14%,the pleura located on the mediastinal side accounted for 28.57%,the pleura located on the diaphragm accounted for 7.14%,and the interlobular pleura accounted for It is 7.14%.Among them,12 patients had tumors with a maximum diameter of<5 cm,4 patients had tumors with a maximum diameter of 5-10 cm,and 12 patients had tumors with a maximum diameter of≥10 cm.The average tumor diameter was(8.90±0.32)cm.Twenty-eight patients with pleural solitary fibroma were diagnosed by immunohistochemistry and histopathology.They were all single lesions,and 8 lesions were pedicled,of which 22 patients were benign and 6 patients were low-grade malignant.Uneven scan density and uniform contrast,the difference was statistically significant(χ^2=8.763,P<0.05);uniform enhancement and map-like enhancement,the difference was statistically significant(χ^2=14.049,P<0.05);enhancement characteristics Uneven and uniform contrast,the difference was statistically significant(χ^2=14.049,P<0.05);non-cystic necrosis vs.cystic necrosis,the difference was statistically significant(χ^2=14.933,P<0.05);whether there are intratumoral blood vessels In comparison,the difference was statistically significant(χ^2=14.933,P<0.05);compared with low-grade malignant and benign,the difference was statistically significant(χ^2=10.182, P<0.05);com

关 键 词：胸膜 孤立性纤维瘤 MSCT影像 

分 类 号：R730.4[医药卫生—肿瘤]