| 周建军,周康荣,曾蒙苏,王建华,纪元,丁建国.血管外皮细胞瘤与孤立性纤维瘤的诊断和鉴别诊断[J].中国医学影像技术,2008,24(4):570~573 |
| 血管外皮细胞瘤与孤立性纤维瘤的诊断和鉴别诊断 |
| Hemangiopericytoma and solitary fibrous tumor: image diagnosis and differential diagnosis |
| 投稿时间：2007-06-11 修订日期：2008-02-29 |
| DOI： |
| 中文关键词: 孤立性纤维瘤 血管外皮细胞瘤 诊断显像 |
| 英文关键词:Solitary fibrous tumor Hemangiopericytoma Diagnostic imaging |
| 基金项目: |
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| 摘要点击次数: 2017 |
| 全文下载次数: 983 |
| 中文摘要: |
| 目的 血管外皮细胞瘤和孤立性纤维瘤同属纤维母细胞/肌纤维母细胞来源肿瘤的中间性肿瘤,病理和组织学方面重叠表现多,术前误诊率高。本文分析各自影像学特征,探讨其影像学诊断和鉴别诊断的价值。方法 回顾性分析经手术病理证实的9例血管外皮细胞瘤和8例孤立性纤维瘤病例,术前经螺旋CT或MR检查,仔细复习CT和MRI扫描结果并和手术病理作回顾性对照分析。结果 9例血管外皮细胞瘤病灶中,位于颅内3例,四肢4例,腹膜后1例,腹股沟1例;肿瘤直径4.8~13.5 cm,平均6.7 cm;瘤内见蚯蚓和结节状异常信号6例,不同程度坏死9例;所有肿瘤实质成分T1WI为等或略低信号,T2WI为略高信号;其中,6例行动态增强,动脉期显著强化5例,中等程度强化1例,所有病例门脉期强化程度与血管相仿。8例孤立性纤维瘤中,位于胸部4例,四肢2例,腹腔1例,盆腔1例;肿瘤直径4.0~22.5 cm,平均9.3 cm;密度或信号较均匀5例,不同程度坏死3例,伴点状钙化1例。CT平扫密度与肌肉密度相仿,内可见两种不同密度的实质成分;CT动脉期呈地图样或线样葡行强化,门脉期持续强化,强化趋于均匀;MRSE T1WI呈等信号,T2WI为略高信号,T2WI脂肪抑制为高信号;MR动脉期明显强化,门脉期持续强化。结论 血管外皮细胞瘤和孤立性纤维瘤具有较明显的影像学特征,影像学可以诊断和鉴别多数病例。 |
| 英文摘要: |
| Objective To investigate the image features of hemangiopericytoma and solitary fibrous tumor and to evaluate their diagnostic value. Methods Nine cases with hemangiopericytoma and 8 cases with solitary fibrous tumor confirmed by surgical pathology underwent both CT and MR plain scan and multi-phases dynamic enhancement scan before operation. The imaging data were reviewed and analysed retrospectively in comparison with surgical and pathological results. Results The hemangiopericytomas were located in intracranium (n=3), limbs (n=4), retroperitoneum (n=1) and inguen (n=1), respectively, the diameter of which was 4.8-13.5 cm with a mean diameter of 6.7 cm. The tumor presented slightly low to iso signal intensity on SE T1-weighted imaging and iso to slightly high signal intensity on FSE T2-weighted imaging with different degree necrosis, 6 cases of which underwent dynamic MR enhancement scanning presented inhomogeneous delayed contrasted-enhancement which was similar to enhancement vessel. The solitary fibrous tumors with well-defined margins were located in the chest (n=4), limbs (n=2), intra-abdomen (n=1) and the pelvis (n=1), respectively, the diameter of which was 4.0-22.5 cm with a mean diameter of 9.3 cm. The tumor presented inhomogeneous solid attenuation which strikingly demonstrated two different solid components on plain scan, and presented geographic pattern, serpiginous linear enhancement with irregular small areas of low attenuation (necrosis) at contrast enhanced CT. On MRI, homogeneous isointensity on T1-weighted images, hyperintense on FSE T2WI images and intense enhancement on postcontrast were seen. Conclusion The imaging features of hemangiopericytoma and solitary fibrous tumor are obvious. Dynamic CT and MR scans can suggest the diagnosis. |
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