目的：探讨胸部孤立性纤维瘤（SFT）的CT表现，以提高对该病的认识。方法：回顾性分析25例经手术病理证实的胸部SFT的CT平扫及增强资料。结果：25例病变均为单发，23例起源于胸膜，2例起源于肺组织。病变的平均最大径为10.9 cm，呈圆形或类圆形，10（10/25）例有分叶，4（4/25）例有钙化，边界均较清楚。平扫CT上，6（6/9）例表现为不均匀密度肿块，3（3/9）例表现为均匀等密度肿块。增强后，大部分（15/21）肿块呈中度或明显不均匀性强化，类似“地图样”改变。14例肿块内部在动脉期可见明显强化的血管影，杂乱分布。8例内部见多发结节状强化，13例内见斑片状、囊状不强化区。以最大径10.0 cm为界值，不同大小SFT的部分CT表现有显著性差异（P＜0.05）。结论：胸部SFT在CT上常表现为单发、体积巨大、边界清楚、包含多种密度的肿块，多发结节状强化及内部杂乱的血管影是其增强特征。
Abstract
Objective: To investigate the CT findings of thoracic solitary fibrous tumors(SFT). Methods: CT images of 25 patients with thoracic SFT confirmed by surgery and pathology were retrospectively analyzed. Results: All cases had single lesion. Twenty-three lesions originated from the pleura, 2 lesions from the lung. The mean diameter of the 25 lesions is 10.9 cm on CT images. All lesions presented as round or oval with well-defined margins, in which 10 cases(10/25) were lobulated, 4 cases(4/25) had calcification. On plain CT, heterogeneous density was showed in 6 cases(6/9), and homogenous isodensity was showed in 3 cases(3/9). On contrast enhanced CT, unevenly moderate or intensive enhancement presented as “geographic pattern” was demonstrated in 15 cases(15/21). Disorganized vessels with obvious enhancement were showed in 14 masses during arterial phase. Multiple nodular enhancement was seen in 8 masses, pathy and cystic non-enhancement areas were seen in 13 cases. There are significant differences in some CT findings between different size of SFT(P＜0.05). Conclusion: Thoracic SFT usually presents as single, huge mass with well-defined margins and contains various components. Multiple nodular enhancement and inner vessels in disorder are the characteristics of thoracic SFT on contrast-enhanced CT images.
关键词
纤维瘤 /
胸部肿瘤 /
体层摄影术 /
螺旋计算机
Key words
Fibroma /
Thoracic neoplasms /
Tomography, spiral computed
中图分类号：
R734.3
Ｒ730.262
Ｒ814.42
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1]Cardillo G, Lococo F, Carleo F, et al. Solitary fibrous tumors of the pleura[J]. Curr Opin Pulm Med, 2012, 18(4): 339-346.
[2]Vejvodova S, Spidlen V, Mukensnabl P, et al. Solitary fibrous tumor-less common neoplasms of the pleural cavity[J]. Ann Thorac Cardiovasc Surg, 2017, 23(1): 12-18.
[3]Song SW, Jung JI, Lee KY, et al. Malignant solitary fibrous tumor of the pleura: computed tomography-pathological correlation and comparison with computed tomography of benign solitary fibrous tumor of the pleura[J]. Jpn J Radiol, 2010, 28(8): 602-608.
[4]Thorgeirsson T, Isaksson HJ, Hardardottir H, et al. Solitary fibrous tumors of the pleura: an estimation of population incidence[J]. Chest, 2010, 137(4): 1005-1006.
[5]Abu Arab W. Solitary fibrous tumors of the pleura[J]. Eur J Cardiothorac Surg, 2012, 41(3): 587-597.
[6]Tapias LF, Mercier O, Ghigna MR, et al. Validation of a scoring system to predict recurrence of resected solitary fibrous tumors of the pleura[J]. Chest, 2015, 147(1): 216-223.
[7]Lococo F, Cesario A, Cardillo G, et al. Malignant solitary fibrous tumors of the pleura: retrospective review of a multicenter series[J]. J Thorac Oncol, 2012, 7(11): 1698-1706.
[8]Zhu Y, Du K, Ye X, et al. Solitary fibrous tumors of pleura and lung: report of twelve cases[J]. J Thorac Dis, 2013, 5(3): 310-313.
[9]Huang SC, Li CF, Kao YC, et al. The clinicopathological significance of NAB2-STAT6 gene fusions in 52 cases of intrathoracic solitary fibrous tumors[J]. Cancer Med, 2016, 5(2): 159-168.
[10]Gengler C, Guillou L. Solitary fibrous tumor and hemangio-pericytoma: evolution of a concept[J]. Histopathology, 2006, 48(1): 63-74.
[11]项光涨，丁国勇，刘克昌，等. 胸膜孤立性纤维瘤的影像学诊断[J]. 中国临床医学影像杂志，2015，26（11）：827-830.
[12]李建鹏，谢传森，张嵘，等. 孤立性纤维瘤的影像学表现与临床病理特征[J]. 中华肿瘤杂志，2010，32（5）：363-365.
[13]张永华，巴照贵，赵绍宏. 胸部孤立性纤维瘤的MSCT表现[J]. 中国医学影像学杂志，2010，18（5）：443-447.
[14]彭小芳，汪秀玲，张秀莉. 孤立性纤维瘤的临床、病理及影像学表现[J]. 中国CT和MRI杂志，2013，11（2）：60-62.
[15]Ginat DT, Bokhari A, Bhatt S, et al. Imaging features of solitary fibrous tumors[J]. AJR, 2011, 196(3): 487-495.
[16]Lococo F, Rapicetta C, Ricchetti T, et al. Diagnostic pitfalls in the preoperative 18F-FDG PET/CT evaluation of a case of giant malignant solitary fibrous tumor of the pleura[J]. Rev Esp Med Nucl Imagen Mol, 2014, 33(2): 109-111.
[17]李辉，陈自谦，姚丽青，等. 良恶性孤立性纤维瘤的影像诊断及病理对照[J]. 实用放射学杂志，2012，28（4）：519-522.
[18]Chu X, Zhang L, Xue Z, et al. Solitary fibrous tumor of the pleura: an analysis of forty patients[J]. J Thorac Dis, 2012, 4(2): 146-154.
