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目的探讨多层螺旋CT/MRI对孤立性纤维性肿瘤(SFTs)的诊断价值。方法回顾性分析经病理及免疫组织化学证实的22例SFTs患者的MSCT/MRI影像特点,并与组织病理学结果进行对照。结果所有病例均为单发,肿瘤位于胸部6例,腹盆部12例,颅内1例,面部1例,椎管内1例,大腿1例。15例行CT检查,4例行MRI检查,3例同时行CT和MRI检查。MSCT/MRI平扫显示肿块大小、形态多变,肿块最大径1.2~25.0 cm,平均(7.6±6.9)cm;肿块呈圆形或椭圆形17例,呈分叶状2例,不规则形3例。MSCT平扫5例密度不均匀,MRI平扫3例信号混杂;16例行MSCT和/或MRI对比增强后4例均匀强化,12例不均匀强化,其中3例肿块内可见增强血管。病理学检查提示恶性SFTs 5例,良性17例。镜下显示肿瘤细胞呈梭形,排列方式多变,间质内见大量薄壁血管;免疫组织化学:Desmin(-)21例,CD34(+)21例,Bcl 2(+)19例,CD99(+)9例;良性SFTs Ki-67≤5%,恶性SFTs Ki-67≥10%。结论 SFTs患者的CT/MRI表现有一定特征性,CT/MRI检查对SFTs的定位及明确肿瘤的良恶性有价值。
Objective To investigate the value of multi-slice spiral CT / MRI in the diagnosis of solitary fibrous tumors (SFTs). Methods The MSCT / MRI features of 22 SFTs confirmed by pathology and immunohistochemistry were analyzed retrospectively and compared with histopathological results. Results All cases were solitary. The tumors were located in 6 cases in the chest, 12 cases in the abdomen, 1 case in the skull, 1 case in the face, 1 case in the spinal canal and 1 case in the thigh. CT was performed in 15 cases, MRI was performed in 4 cases and CT and MRI were performed in 3 cases at the same time. MSCT / MRI showed the size of the mass on a plain scan. The maximum diameter of the mass was 1.2 ~ 25.0 cm, with an average of (7.6 ± 6.9) cm. The mass was round or oval in 17 cases, lobulated in 2 and irregular example. MSCT scan of 5 cases of uneven density, 3 cases of MRI plain scan signal mixed; 16 cases of MSCT and / or MRI contrast enhanced 4 cases of uniform enhancement, 12 cases of uneven enhancement, including 3 cases of enhanced blood vessels visible mass. Pathological examination showed malignant SFTs in 5 cases, benign in 17 cases. Microscopically, the tumor cells were spindle-shaped and varied in arrangement, with a large number of thin-walled vessels in the interstitium. Immunohistochemistry: 21 cases of Desmin (-), 21 cases of CD34 (+), 19 cases of Bcl 2 (+) 9 cases; benign SFTs Ki-67≤5%, malignant SFTs Ki-67≥10%. Conclusion The CT / MRI findings of patients with SFTs have certain characteristics. The CT / MRI examination of SFTs and the value of definite benign and malignant tumors are valuable.