| 李新春,钱元新,曾庆思,伍筱梅,张卫东,何建勋,关照坤.胸膜孤立性纤维瘤的影像学表现及误诊原因分析[J].中国医学影像技术,2009,25(2):254~256 |
| 胸膜孤立性纤维瘤的影像学表现及误诊原因分析 |
| Imaging characteristics of solitary fibrous tumor of the pleura and analysis of 16 misdiagnosed cases |
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| DOI： |
| 中文关键词: 孤立性纤维瘤 胸膜 体层摄影术,X线计算机 磁共振成像 |
| 英文关键词:Solitary fibrous tumors Pleura Tomography, X-ray computed Magnetic resonance imaging |
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| 中文摘要: |
| 目的 观察胸膜孤立性纤维瘤(SFTP)的CT、MRI 表现, 探讨影像学误诊的原因。方法 回顾性分析经手术病理证实的16例SFTP的CT、MRI表现,16例术前均接受CT平扫及增强检查,6例患者同时接受MR平扫及增强检查。全部病例术前影像学检查均误诊。结果 本组16例CT均表现为胸腔单发实性肿块,9例为胸部单发巨大肿块占位病变,边缘清晰,7例为胸壁结节状肿块,肿瘤直径2.0~16.5 cm,平均12.8 cm;密度均匀(5例)或不均匀(11例),2例出现中央斑点状钙化。MR T2WI上6例SFTP为不均匀低信号,4例瘤内见坏死、囊变区;增强扫描强化明显,本组16例中6 例巨大肿瘤内见较多肿瘤血管,肿瘤不均匀强化呈"地图样",邻近肺组织受压;3例见少量胸腔积液。结论 CT、MRI可清晰显示SFTP病灶的大小、形态及与周围组织的关系,但 CT检查无特征性表现;MR T2WI出现特征性低信号时可提示诊断,确诊仍需病理学及免疫组化检查;对本病认识不足是术前误诊的主要原因。 |
| 英文摘要: |
| Objective To observe CT and MRI features of solitary fibrous tumor of the pleura (SFTP), and to analyze causes of misdiagnosis of this disease. Methods CT and MRI findings of 16 patients of SFTP confirmed by pathology were retrospectively analyzed. All patients underwent plain and enhancement CT scans,while 6 of them underwent plain and enhancement MR scan before operation but all were misdiagnosed. Results With CT scan, single tumor in thoracic cavity was found in all 16 patients, large mass with well-defined margin was detected in 9, while single node in chest wall was depicted in 7, the mean diameter of tumors was 12.8 cm (2.0－16.5 cm) with homogeneous (n=5) or nonhomogeneous density (n=11). Stippled calcification was found in center of tumor in 2 patients. On MRI, 6 lesions demonstrated heterogeneous low signal intensity on T2WI, 4 were found with intra-tumor necrosis and cystic areas. Obvious homogeneous or nonhomogeneous enhancement was detected in 6 patients, and "geographic pattern" was found in 6 large tumors compression atelectasis happened in the adjacent lung caused by large lesions, and ipsilateral pleural effusion was observed in 3 patients. Conclusion CT and MRI can clearly reveal the size and the relation of SFTP to adjacent structures. Specific CT manifestition of SFTP are not availible.Though low signal on T2WI may suggest the diagnosis of SFTP, the final diagnosis depends on pathology and imununohistoehemistry. Insufficient awareness is the main cause of misdiagnosis of SFTP. |
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