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1、医学影像学杂志2008年第18卷第8期JMedImagingVol.18No.82008孤立性纤维瘤的影像学诊断和鉴别周建军,周康荣,曾蒙苏,王建华,程伟中,丁建国,纪元(复旦大学附属中山医院放射科,上海市影像医学研究所上海200032)=摘要>目的:分析孤立性纤维瘤CT、MR平扫和增强的影像学表现,探导其影像学诊断价值。方法:回顾性分析8例经手术病理证实的孤立性纤维瘤病例,7例术前经螺旋CT或多层螺旋CT平扫或增强检查,1例经MR动态增强检查。所有病例影像资料均经3名高年医师分析阅片,分别确定病灶境界、大小
2、、密度和强化程度等,并与手术病理进行对照。结果:8例孤立性纤维瘤病例中,位于胸部4例,四肢2例,腹腔1例,盆腔1例。肿瘤直径4.0~22.5cm,<5cm1例,5~10cm3例,>10cm4例,平均9.3cm。边缘光滑,境界清楚。瘤体呈圆形或椭圆形5例,梭形3例;5例肿瘤密度相对均匀或略不均匀,内可见两种明显不同密度的实质成分。3例可见不规则坏死区,坏死面积相对很小。较小病灶形态规则,巨大病灶多呈分叶状。CT增强病灶呈地图样强化和匐形线条样强化,动脉期轻微强化~显著强化,门脉期持续强化,强化趋于均匀。MRSE
3、T1WI呈等信号,T2WI为略高信号,T2WI脂肪抑制为高信号,MR动态增强强化显著。结论:SFT典型影像学表现包括:肿瘤密度相对均匀,境界清楚,瘤内常见两种不同密度的实质成分,MRT2WI多表现为略高信号中夹杂片状低信号区,动态增强强化差异大。=关键词>纤维母细胞/肌纤维母细胞肿瘤;孤立性纤维瘤;体层摄影术,X线计算机中图分类号:R734;R814.42文献标识码:A文章编号:1006-9011(2008)08-0851-04Solitaryfibroustumor:theimagingdiagnosisa
4、nddifferentialdiagnosisZHOUJian-jun,ZHOUKang-rong,ZENGMeng-su,WANGJian-hua,CHENGWei-zhong,DINGJian-guo,JIYuanDepartmentofRadiology,ZhongshanHospital,FudanUniversity,Shanghai200032,P.R.China=Abstract>Objective:ExploringtheCTandMRIfindingsofsolitaryfibroustum
5、orandevaluatingit.sclinicalvalue.Methods:All8casesofpatientswithsolitaryfibroustumorconfirmedbysurgicalpathologyunderwentCTandMRplainscanningandmult-iphasesdy-namicenhancementscanningbeforeoperation,theimagingdatawasreviewedandanalysedretrospectivelyincompa
6、risonwithsurgicalandpathologicalresults.Results:4of8patientswithsolitaryfibroustumorwerelocatedinthechest,2inthefourlimbs,1inintra-abdominaland1inthepelvis.Theaveragetumorsizewas9.3cm(range,4.0~22.5cm)with1case<5.0cm,3cases5.0~10.0cmand4cases>10cm.Thetumorp
7、resentedroundorellipsein5casesandshuttleshapein3caseswithwel-ldefinedmarginsandsmoothcon-tours.AtunenhancedCT,theyshowedrelativelyhomogeneousattenuationin5caseswhichstrikinglydemonstratedtwodifferentsolidcomponentsandinhomogeneousattenuationin2cases.Typical
8、featuresofsmalllesionswerewel-ldefinedmarginsandsmoothcontours,largerlesionswerecharacterisedbywel-ldefinedmarginsandlobulatedcontours.AtcontrastenhancedCT,theywereinhomogeneouswithgeographicpattern,se
