良恶性孤立性纤维性肿瘤的影像学表现

发布时间：2018-04-28 22:39

本文选题：孤立性纤维瘤 + 体层摄影术　；参考：《中国医学影像学杂志》2015年06期

【摘要】：目的探讨良恶性孤立性纤维性肿瘤(SFT)的影像学特征,提高其影像诊断水平。资料与方法回顾性分析经手术病理证实的24例SFT的术前CT及MRI资料,观察肿瘤部位、大小、形态、密度(信号)、增强类型及与周围组织的关系,其中MRI平扫7例,增强扫描5例;CT平扫17例,增强扫描11例;并与病理结果进行对照。结果 23例瘤体呈实性,1例呈囊实性。影像诊断20例良性,2例恶性,2例良性误诊为恶性,影像诊断符合率为91.7%(22/24)。5例良性肿瘤(最大直径4 cm)密度均匀,7例(最大直径5 cm)密度不均,4例钙化,7例出现坏死,呈类圆形或不规则形。CT增强扫描后进行性增强型5例,速升缓降型5例,轻度强化型1例。MRI平扫肿瘤实质部分4例T1WI呈等信号,T2WI呈等、稍高信号;3例T1WI呈等、低信号,T2WI呈等、低或稍高混杂信号,DWI呈稍高信号,增强扫描后实质部分均明显强化;2例恶性肿瘤密度不均,边界不清,均有周围浸润性改变,增强扫描呈进行性强化。病理提示肿瘤主要由梭形细胞构成,并富含纤维及血管。结论良恶性SFT的影像学表现有一定的特征,出现侵袭性生长为恶性SFT影像诊断的可靠征象。MRI出现T1WI或T2WI呈等、低信号的实质部分明显强化征象有助于SFT的诊断,最终确诊依靠病理检查。
[Abstract]:Objective to investigate the imaging features of benign and malignant solitary fibrous tumor (SFT) and to improve its diagnostic level. Materials and methods the preoperative CT and MRI findings of 24 cases of SFT proved by operation and pathology were retrospectively analyzed. The tumor location, size, morphology, density (signal intensity, enhancement type and relationship with surrounding tissues) were observed. MRI scan was performed in 7 cases. Contrast-enhanced CT scan was performed in 17 cases and contrast-enhanced scan in 11 cases, which was compared with pathological findings. Results there were 23 cases with solid tumor and 1 case with solid tumor. 20 cases of benign tumor and 2 cases of malignant tumor were misdiagnosed as malignant. The coincidence rate of imaging diagnosis was 91.7% 22 / 24.5 cases of benign tumor (maximum diameter 4 cm), 7 cases of homogeneous density (5 cm of maximum diameter), 4 cases of calcification and 7 cases of necrosis. There were 5 cases of progressive enhancement, 5 cases of rapid rise and slow decline, 1 case of mild enhanced type, 4 cases of T1WI with isointense T 2WI, 3 cases of T1WI with slightly high signal intensity, and 5 cases of low signal intensity T 2WI. Low or slightly high mixed signal intensity on DWI showed a slight hyperintensity. After contrast enhancement, the solid part was obviously enhanced in 2 cases, the density of malignant tumor was uneven, the boundary was not clear, there were peripheral infiltrative changes, and enhanced scan showed progressive enhancement. Pathology suggests that the tumor is mainly composed of fusiform cells and is rich in fibers and blood vessels. Conclusion the imaging features of benign and malignant SFT have some certain characteristics. Invasive growth is a reliable sign for the diagnosis of malignant SFT. T1WI or T2WI is presented in MRI. The enhancement of hypointensity is helpful to the diagnosis of SFT. The final diagnosis depends on pathological examination.
【作者单位】：徐州医学院附属医院影像科;连云港市第二人民医院影像科;
【分类号】：R730.44

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