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目的探讨头颈部孤立性纤维瘤(SFT)的影像学特征,提高对本病罕见部位的认识。方法回顾性分析经手术病理证实的8例头颈部SFT的影像表现。术前行CT检查者5例,4例行增强扫描;行MRI检查者4例,均行增强扫描。其中1例同时行MRI与CT检查。结果 (1)8例头颈部SFT中,海绵窦区-鞍旁1例,甲状腺1例,椎管内2例,翼腭窝2例,颌下1例,颈部1例。肿瘤直径1.4~6.8 cm,呈圆形或卵圆形7例,浅分叶1例。边界清楚8例。(2)5例CT平扫密度均匀,未见囊变、出血、坏死及钙化。1例周围骨质破坏。(3)MRI平扫T_1WI 4例肿瘤主体呈等信号,1例见少许出血灶。3例肿瘤T_2WI呈等低信号,1例高低混杂信号,1例等信号。1例少许囊变坏死灶。1例周围少许水肿。1例DWI高低混杂信号。(4)增强扫描,3例病灶动脉期不均匀强化,5例均匀强化,4例见迂曲管影,T_2WI低信号区也呈明显强化;静脉期渐进性均匀强化。结论头颈部SFT影像表现具有一定的特点,T2WI信号更为典型,当肿瘤T_2WI信号混杂,与DWI信号相对应,且T_2WI低信号区明显强化,有利于诊断SFT。
Objective To investigate the imaging features of head and neck solitary fibroma (SFT) and to improve the understanding of the rare site of this disease. Methods Eight cases of head and neck SFT confirmed by surgery and pathology were retrospectively analyzed. Preoperative CT examination in 5 cases, 4 cases of enhanced scanning; line MRI in 4 cases, were performed enhanced scan. In one case, MRI and CT were performed at the same time. Results (1) 8 cases of head and neck SFT, cavernous sinus area - a case of parasella, thyroid in 1 case, 2 cases of spinal canal, pterygopalatine fossa in 2 cases, 1 case of submandibular and 1 case of neck. Tumor diameter 1.4 ~ 6.8 cm, round or oval in 7 cases, 1 case of shallow leaves. Clear border in 8 cases. (2) 5 cases of CT scan density uniform, no cystic change, bleeding, necrosis and calcification. One case of bone destruction around. (3) MRI plain scan T_1WI 4 cases showed tumor signal equal, a case of a small hemorrhage. Three cases of tumor T_2WI showed low signal, 1 case of mixed signal, 1 case of other signals. 1 case of cystic necrosis. 1 case of small edema around. One case of DWI mixed signal level. (4) enhanced scan, 3 cases of lesions of the arterial uneven enhancement, 5 cases of uniform enhancement, 4 cases see the tortuous tube, T_2WI low signal area was also significantly enhanced; venous progressive enhancement. Conclusion The SFT images of head and neck have certain characteristics. The T2WI signal is more typical. When T_2WI signal of tumor is mixed, it corresponds to DWI signal, and the low signal area of T_2WI is obviously strengthened, which is in favor of diagnosing SFT.