胸膜孤立性纤维瘤的影像学诊断

目的 探讨胸膜孤立性纤维瘤的CT及MRI表现及其诊断价值.资料与方法 对11例经手术病理证实的胸膜孤立性纤维瘤患者的CT及MRI表现特征进行回顾性分析.结果 11例11个病灶,7例来源于右侧胸膜,其中斜裂胸膜2例,水平裂胸膜3例;左侧胸膜4例,其中斜裂胸膜2例,CT表现为边界清晰的混杂密度影,其内见不规则低密度区,2例可见结节状钙化,增强扫描实性部分不同程度强化,低密度区无强化,9例可显示肿瘤内血管;MRI表现为边界清晰的混杂信号实性部分T_1WI与肌肉相比呈高信号,T_2WI呈等或稍低信号,囊变部分表现为长T_1、长T_2信号,扩散加权成像(DWI)表现为等或稍高信号;增强扫描肿瘤实性部分不同程度强化.结论 胸膜孤立性纤维瘤的CT及MRI表现有一定的特征,分析其影像学特征,可做出较明确的诊断并能够与其他胸部肿瘤相鉴别.

Imaging Diagnosis of the Solitary Fibrous Tumors of Pleura

Objective To investigate the CT and MRI characteristics and diagnostic value of solitary fibrous tumors of pleura (SFTP). Materials and Methods MRI and CT appearances of 11 patients with SFTP confirmed by pathology were reviewed retrospeetively. Results The tumors originated from right pleura in 7cases,from oblique fissure in 2, from horizontal fissure in 3 ; from right pleura in 4, from oblique fissure in 2. All the lesions had clear margin. Central small low attenuation was seen in all cases on plain CT scans. Calcification was found in 2 cases. After contrast enhancement, the lesions enhanced evidently, homogenous enhancement was seen in 2 cases and inhomogenous enhancement in 9 eases. On MRI, all lesions showed slightly hypo or isointense T_2 signal and slightly low-intense T_1 signal compared with muscle of thoracic wall. The cystic and necrotic degeneration showed long T_1 and long T_2 signals. The margins of all tumor were clearly defined. GD-DTPA was performed in all cases and the soft tissue mass showed enhancement evidently. Conclusion The CT and MRI findings of SFTP have some characteristic features and accurate diagnosis can be made in typical cases.