肺外孤立性纤维瘤的MRI表现及病理基础  

Extra-Pleural Solitary Fibrous Tumor:MRI Findings and Pathological Basis

作　　者：江少凡[1] 冯昌银[2] 蒋日烽[1] JIANG Shaofan;FENG Changyin;JIANG Rifeng(Department of Radiology,Fujian Medical University Union Hospital,Fuzhou,Fujian Province 350001,P.R.China)

机构地区：[1]福建医科大学附属协和医院CT室,福州350001 [2]福建医科大学附属协和医院病理科,福州350001

出　　处：《临床放射学杂志》2021年第6期1102-1105,共4页Journal of Clinical Radiology

摘　　要：目的探讨肺外孤立性纤维瘤(ESFT)的MRI表现,结合病理基础,提高对本病的诊断水平。方法回顾性分析经手术病理证实的11例ESFT的MRI及病理学表现。结果11例ESFT中,发生在泌尿生殖系统3例(阴囊2例,膀胱1例),盆腹腔4例,中枢神经系统3例,头颈部1例。3例恶性或侵袭性,T_(1)WI均呈等高混杂信号,T_(2)WI上2例为等高混杂信号,1例为高信号,DWI仅边缘高信号;8例为良性,T_(1)WI上病灶均呈等低信号,T_(2)WI上2例为均匀低信号,6例病灶表现为高低混杂信号,DWI呈等低信号,增强扫描实性区域均强化明显,坏死囊变区未见强化。4例可见明显滋养血管,8例ESFT的T_(2)WI低信号区显著强化。免疫组织化学:CD34阳性(5/6),Bcl-2阳性(6/6),Vimentin阳性(6/6),S-100阴性(6/6),平滑肌肌动蛋白(SMA)阴性(6/6),Ki-67=1~2%(3/3),Ki-67=30%(1/1)。结论肺外孤立性纤维瘤MRI信号与纤维、坏死囊变区含量和分布有关,增强扫描呈"快进慢出"的特点,瘤周或瘤内可见滋养血管,T_(2)WI低信号区域的明显强化是其主要特点。Objective To analyze the MRI findings and corresponding pathological basis of extra pleural solitary fibrous tumor(ESFT)and to improve the diagnostic ability.Methods MRI and pathological findings were retrospectively reviewed in 11 patients with ESFT proved by operation and pathology.Results The tumors were found in genitourinary system in 3 cases(2 in Testis,1 in Bladder),Pelvic Cavity in 4 cases,central nervous system in 3 cases and periorbital in 1 case.3 cases were malignant or invasive,the lesions presented isointensity on T_(1)WI,hyper or isointensity on T_(2)WI,DWI only shows high marginal signal.8 cases were benign,the lesions presented isointensity or low signal on T_(1)WI,hyper or isointensity on T_(2)WI in 6 cases and low signal on T_(2)WI in 2 cases.On contrast enhanced MRI,DWI showed no abnormal hyperintensity.Solid parts of the mass showed intensive enhancement.Obvious trophoblastic vessels were seen in 4 cases.Immunohistochemical staining showed that CD34(5/6),Bcl 2(6/6),Vimentin positive(6/6)and Ki-67(1-2%)(3/3),Ki-67=30%(1/1),as well as negative S-100(6/6),SMA(6/6).Conclusion The MRI signal of extrapulmonary solitary fibroma is related to the content and distribution of fibrous and necrotic cystic areas.Trophoblastic vessels can be seen around or inside the tumor,and the obvious enhancement of low signal area on T_(2)WI is the main characteristic.

关 键 词：孤立性纤维瘤 磁共振成像 病理学 

分 类 号：R734.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学]