孤立性纤维瘤的影像诊断分析

目的总结不同部位起源的孤立性纤维瘤的影像特点,提高对该疾病的影像学认识。方法回顾性分析18例(17例CT平扫加增强、1例MRI平扫加增强)全身不同部位起源并经手术病理及免疫组化证实为孤立性纤维瘤患者的资料,分析上述CT及MRI图像及肿块的影像表现。结果 18例患者中,5例起源于胸膜,2例起源于腹膜后,其余起源于脑实质、腮腺、咽旁间隙、颈肩部肌间隙、肺、肝、前纵膈、空肠、肾、盆腔、子宫圆韧带均1例;肿块均单发,呈边界清分叶状的实性肿块,且不均匀强化,最大径线为13cm,除1例恶变伴双肺多发转移外,其余均为良性。结论孤立性纤维瘤可发生于胸膜及其以外的多个部位或器官,巨大边界清楚呈分叶状的不均匀密度/信号肿块,且明显不均匀强化时,应注意孤立性纤维瘤的可能。

Imaging Diagnosis and Analysis for Solitary Fibrous Tumor

Objective To summarize and analyze the imaging findings of solitary fibrous tumor in different anatomic locations and further to improve the imaging understanding for this disease.Methods A total of 18 cases (17 underwent enhanced and non-enhanced CT scan,1 with enhanced and non-enhanced MR scan) with solitary fibrous tumor confirmed by pathology and immunohistochemistry technique were retrospectively analyzed ,which included the clinical material and imaging findings. Those tumors were originated from different anatomic locations.Results 5 out of 18 solitary tumors originated from pleura,2 from kidney, the remaining 11 were originated from brain, parotid, parapharyngeal space, intermuscular space in neck and shoulder, lung, liver, anterior mediastinum, jejunum, retroperitoneal space, pelvis, round ligament of uterus respectively, which manifest as well-defined lobular solid mass with obvious heterogeneous enhancement. In those tumors, the largest maximum diameter was 13cm.All tumor were confirmed to be benign except one was malignant combined with multiple lung metastasis.Conclusion Solitary fibrous tumor can occur in different anatomic locations besides the pleura. When a tumor presenting as large lobular well-defined solitary tumor with heterogeneous attenuation/intensity especially show obvious enhancement, solitary fibrous tumor should be considered.