胸部孤立性纤维瘤的CT表现与鉴别诊断-现代仪器与医疗.PDFVIP

《现代仪器与医疗》 2017年  第23卷   第3期 影像介入 胸部孤立性纤维瘤的CT表现与鉴别诊断 龚健　唐翠松　汤光宇 （上海同济大学附属第十人民医院放射科，上海　200072 ） [摘　要]　目的：观察胸部孤立性纤维瘤（pleural solitary fibrous tumor ，PSFT ）的CT 表现，总结鉴别诊断策略。 方法：分析24 例PSFT 患者CT 平扫和增强征象以及病理表现。结果：均为胸腔内单发肿块，CT 平扫可见软组 织肿块且边缘光滑，与胸壁或纵膈间夹角呈钝角，可见胸膜轻微局限掀起，呈胸膜尾征；19 例肿瘤密度相对均匀， 5 例瘤体较大者，肿瘤内部密度欠均匀。12 例增强扫描可见不均匀强化，以肿瘤中心点状、条状、斑片状不明 显强化为主；10 例肿瘤不同区域可见轻度、中度、显著强化同时存在，以轻度、中度强化为主；9 例肿瘤内部 可见血管影像，局部血供丰富；3 例瘤体增强无特殊变化。22 例肿瘤边缘与周围组织界限清晰，肿瘤包膜完整， 周围组织受压明显，1 例肿瘤可见瘤蒂，1 例肿瘤因侵犯纵膈、心包局部致使界限不清。病理结果显示24 例中 18 例来源于脏层胸膜，6 例来源于壁层胸膜。结论：PSFT 的CT 表现具有较高特征性，结合肿瘤定位及其与周 边组织结构的关系有助于本病的鉴别诊断。 [关键词]　胸部孤立性纤维瘤；CT ；影像学；鉴别 中图分类号：R445　文献标识码：A　文章编号：2095-5200(2017)03-001-03 DOI：10.11876/mimt201703001 CT manifestations and differential diagnosis of pleural solitary fibrous tumor　GONG Jian, TANG Cuisong, TANG Guanyu. Departmen of Radiology,Shanghai Tenth People’s Hospital, shanghai, （ 200072,china ） [Abstract]　Objective: This study was designed to observe the CT manifestations of pleural solitary fibrous tumor (PSFT), and to summarize the diagnostic criteria. Methods: CT scan, enhancement signs and pathologic features of 24 patients with PSFT were analyzed. Results: All patients manifestated with single-intracavitary mass, CT scan showed a soft tissue mass with smooth edges, and the angle between that and the chest wall or mediastinum was obtuse, showed the pleura raised slightly and limitedly, manifestated with pleural indenlation sign; the tumor density of 19 cases was homogeneous, the internal density of the tumor in 5 cases of large tumor was less homogeneous. 12 cases of enhanced scan showed uneven enhancement, mainly presented that the punctate, striped and patchy-shaped masses were not significantly enhanced in the center of tumor; the tumors of different regions could be seen mild, moderate and significantly enhanced at the same time in 10 cases, mainly characteri