腹部孤立性纤维瘤的多层螺旋CT表现

目的：探讨腹部孤立性纤维瘤（SFT）的MSCT表现及其病理学特征，提高对本病的影像学认识。方法回顾性分析10例经病理证实的腹膜和腹膜后SFT的MSCT表现、临床及病理资料。结果10例肿瘤4例来自腹膜，6例来自腹膜后间隙，肿瘤均呈椭圆形，边界清楚，1例＜5 cm者密度均匀，9例＞5 cm者密度不均匀，可见低密度坏死区，明显囊变1例，1例肿瘤内见斑片状高密度出血，3例伴有多发小钙化。增强扫描肿块实质部分表现两种强化方式：动脉期、静脉期均为轻度强化3例；动脉期明显不均匀强化、静脉期持续强化者7例。病理学检查肿瘤由多种排列方式的梭形细胞构成，3例恶性SFT可见核分裂。免疫组织化学CD34阳性10例， Vimentin阳性10例，Bcl-2阳性9例。结论 MSCT检查可以对腹部SFT进行明确定位，确定肿瘤与周围组织器官的关系，为手术切除提供帮助，当肿瘤血供丰富、坏死明显、局部包膜不完整时提示可能为恶性SFT，其最终诊断依赖于病理形态学及免疫组织化学检查。

MSCT findings of abdominal solitary fibrous tumor

Objective To explore the MSCT imaging findings and pathological features of abdominal solitory fi-brous tumors（SFT）. Methods The MSCT imaging findings and clinicopathological manifestations were analyzed retro-spectively in 10 patients with surgically confirmed SFT in peritoneum and retroperitoneum. Results The SFT of 4 cases located in the peritoneum and 6 cases in retroperitoneum, all cases showed oval-shaped masses and well defined borders, by MSCT plain scan, the masses presented homogeneous density in 1 case with less than 5 cm in diameter and heterogeneous density in 9 cases with greater than 5 cm which showed low-density necrosis, significant cystic change in 1 case, with patchy high density bleeding in 1 case and multiple small calcifications in 3 cases. there were 2 different enhanced patterns in substantial part of the tumors after injection of Iohexol, including enhanced mildly in arterial phase and venous phase in 3 cases, enhanced markedly in arterial phase and continously enhanced in venous phase in 7 cases. Microscopically, SFTs were composed of spindle cells with various patterns, mitosis was showed in 3 malignant cases. Immunohistochemical staining showed that CD34-positive in 10 cases, Vimentin in 10 cases and Bcl-2 in 9 cases. Conclusion The MSCT examination may serve to provide helpful information as to the location and vicinal anatomic structure of the tumor, which is of substantial importance for planning surgery. Tumor with richly blood supply, obviously necrosis, local envelope incomplete may suggest malignant SFT, the clear diagnosis of SFT is depending on pathological and immunohistochemical examination.