多排螺旋CT对胸膜孤立性纤维瘤诊断价值

摘要

目的 分析胸膜孤立性纤维瘤(SFTP)的多排螺旋CT(MSCT)影像表现,提高对该病的诊断及鉴别诊断能力.方法 经手术病理证实16例胸膜孤立性纤维瘤患者的MSCT图像资料进行回顾性分析,16例均行增强.结果 16例均为胸腔内单发肿块,大小不等,呈类圆形或椭圆形,边界清,直径2.3～19.0cm,12例较大肿块密度不均匀,多数内见囊变及坏死,4例内见钙化,4例小肿块密度均匀,平扫CT值21～37HU,增强后均匀或不均匀持续强化,CT值43～85HU,8例呈“地图样”强化,7例肿瘤内见血管影.7例位于右侧,9例位于左侧,采用多平面重建(MPR)技术进行后处理可进一步明确病变与周围组织的关系.结论 SFTP的MSCT有一定的特征性,MSCT检查有利于明确病变的大小、范围、部位、形态、密度及强化特征,但最终需病理学确诊.%Objective To analyze the CT finding of the solitary fibrous tumor of the pleura (SFTP),and to improve the diagnostic ability of this disease.Methods CT findings of 16 cases of SFTP confirmed by pathology were retrospectively analyzed.All patients underwent CT enhancement scans.Results Solitary tumor in thoracic cavity was found in all 16 patients.The lesions showed the clear edge,and round or oval shape.The tumor diameter was 2.3-19 cm.Tewelve cases showed heterogeneous density,and most of them showed necrosis and cystic areas.Calcification was found in 4 cases.Four cases of small tumors showed homogeneous density with average CT value 21-37HU,and showed homogeneous or heterogeneous enhancement on the post-contrast.Eight cases showed “geographic pattern” enhancement.Seven cases showed disorganized vessels.Seven cases were on right pleura and 9 cases on left.MSCT reconstruction could explore the relation of tumor and the round tissue.Conclusion Some MSCT findings of SFTP were characteristic.MSCT scans have great value for clinic diagnosis and follow-up by providing information including range,location,shape,and disorganized vessels.