胸膜孤立性纤维瘤 MSCT 表现与病理对照研究

目的:探讨胸膜孤立性纤维瘤(SFTP)的MSCT影像学表现及手术病理学形态特点,旨在提高对SFTP的认识及MSCT诊断符合率。方法:搜集经手术病理及免疫组化证实的12例SFTP病例资料,回顾性分析病灶CT平扫、增强动脉期及门脉期影像学表现,并与手术病理结果进行对照分析。结果:所有病灶均与相邻胸膜关系紧密,边界清楚,9例病灶密度均匀;增强扫描动脉期中、重度强化10例,门脉期均持续强化,3例显示瘤体内血管网或供血动脉。肿瘤多有完整假包膜,质地均匀,可伴有出血、粘液样变或囊变;免疫组化显示9例Vim、CD34及Bcl-2均为阳性,11例Ki-67表达小于或等于5%。结论:SFTP典型影像学特征包括:肿瘤边界清楚、密度相对均匀,病灶动脉期中、重度强化伴门脉期持续强化。因此分析肿瘤MSCT表现有助于提高术前诊断的符合率,但确诊仍需依赖手术病理及免疫组化检查。

Study on solitary fibrous tumor of the pleura with multi-slice spiral CT correlated with pathology

Objective:To investigate multi-slice spiral CT (MSCT)findings of solitary fibrous tumor of the pleura (SFTP)cor-relating with pathology,so as to improve the knowledge and diagnostic accuracy of this disease.Methods:12 cases of patients with soli-tary fibrous tumor of the pleura confirmed by surgical pathology and immuno-histochemistry examination were underwent CT and multi-phases enhancement scanning before operation,the imaging data was analyzed retrospectively and correlated with pathological results. Results:All of 12 lesions showed well-circumscribed mass,adjacent to the pleural surface,and homogeneous attenuation in nine cases. At contrast enhanced CT scan,10 lesions presented moderate /severe enhancement at arterial phase,all lesions presented continuously enhancement at portal venous phase,two cases showed abundant vascular network and one case showed the tumor blood supply artery. General pathologic showed tumors with pseudocapsule,homogeneous texture,part of lesions associated with hemorrhage,myxoid changes or cystic degeneration.9 cases had positive vimentin,CD34 and Bcl-2 expression,proliferating cell nuclear antigen Ki-67 expression was less than or equal to 5% in 1 1 cases.Conclusion:The typical imaging manifestations of SFTP show relatively homogeneous attenuation and well-defined margin,arterial phase and portal venous phase have different degrees of tumor enhancement.Therefore analyzing the MSCT findings of tumors are helpful in preoperative diagnosis,but the final definite diagnosis depend on pathology and immunohisto-chemical examination.