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目的分析孤立性纤维瘤(SFT)CT、MR的影像学表现,探讨影像学误诊原因。方法回顾性分析13例经手术病理证实的SFT病例,11例SFT患者行CT平时及增强检查,其中1例同时行MR平扫及增强检查,另2例仅行MR平扫及增强检查。结果 13例孤立性纤维瘤病例全部为单发病灶,位于胸部10例,发生在肾脏、前列腺、下肢各1例。肿瘤直径2.8～22.0cm,直径≤7cm 6例,>7cm 7例,平均9.6cm。11例行CT检查的病例,6例表现为圆形或椭圆形,边缘光滑,境界清楚。密度相对均匀或略不均匀,5例巨大病灶多呈分叶状,内可见不规则坏死区,坏死面积相对较小,1例出现中央斑点状钙化。CT增强检查病灶呈明显均匀强化或地图样强化。3例行MR检查的病例,T1WI呈等或低信号,T2WI2例呈低信号,1例呈高低混杂信号,增强检查病灶显著强化。结论胸膜外SFT与胸膜SFT表现类似,CT、MR可清晰显示病灶的大小、形态及与周围组织的关系,MR显示肿瘤在T2WI上有低信号区,增强扫描肿瘤明显强化时,可提示诊断,确诊仍需病理学及免疫组化检查;对本病认识不足是术前误诊的主要原因。
Objective To analyze the imaging findings of solitary fibrous tumor (SFT) CT and MR and to explore the causes of misdiagnosis of imaging. Methods Thirteen cases of SFT confirmed by surgery and pathology were retrospectively analyzed. Eleven patients with SFT underwent CT plain and enhanced examination. One case underwent MR plain scan and contrast enhancement, the other two cases underwent MR plain scan and enhanced examination. Results All 13 cases of solitary fibroma were single lesions, located in the chest in 10 cases, occurred in the kidney, prostate, lower limb in 1 case. Tumor diameter 2.8 ~ 22.0cm, diameter ≤ 7cm 6 cases,> 7cm 7 cases, an average of 9.6cm. 11 cases of CT examination of the cases, 6 cases showed round or oval, smooth edges, clear realm. The density was relatively uniform or slightly non-uniform. Most of the 5 cases showed lobulated lobectomy. There were irregular necrotic areas and relatively small necrotic areas. One case showed central plaque calcification. CT enhanced examination lesions were significantly enhanced or map-like enhancement. Three cases of MR examination of the cases, T1WI was equal or low signal, T2WI2 cases showed low signal, 1 case showed high and low mixed signals, enhanced examination significantly enhanced lesions. Conclusions Pleural effusion SFT is similar to pleural SFT. CT, MR clearly show the size and shape of the lesion and the relationship with the surrounding tissue. MR shows that the tumor has a low signal area on the T2WI. When the enhanced tumor is markedly enhanced, it can be helpful to diagnose, Confirmed still need pathology and immunohistochemistry; lack of understanding of the disease is the main reason for preoperative misdiagnosis.