【摘要】 目的探讨孤立性纤维瘤(solitary fibrous tumor,SFT)的CT、PET/CT表现及病理特点。方法回顾性分析13例SFT的CT、PET/CT影像表现及病理特点,13例患者均行CT平扫及增强扫描,其中2例行PET/CT扫描,对影像学表现、病理特点进行分析总结。结果①13例SFT患者中,胸部5例,腹部8例,肿瘤直径为3.3～17.8cm,平均7.8cm;肿瘤呈圆形或椭圆形8例,形态不规则5例;边界清楚9例,不清者4例;②CT平扫:密度均匀5例,不均匀8例,1例见高密度出血灶;③CT增强:10个病灶的动脉期呈"地图样"强化,可见多发迂曲供血血管从肿瘤的边缘延伸到肿瘤内部,静脉期呈进行性强化,并有不规则片状、结节状无强化区,3例病灶动脉期及静脉期呈轻至中度不均匀强化;④PET/CT:2例SFT在PET显像均为阳性,其中病灶最大SUV值为5.0,最小SUV值为2.9,延迟显像最大SUV值为2.3;⑤SFT显微镜主要表现为:瘤细胞呈梭形或卵圆形,细胞间可见胶原间质及薄壁的"鹿角状"分支血管。免疫组化:CD34、Vimentin、bcl-2阳性。结论 SFT的CT表现具有一定特点,当见到单发、边界清楚的软组织肿块,密度不均匀,增强扫描动脉期呈"地图样"强化,可见到迂曲强化的血管影延伸到肿瘤内部,静脉期呈进行性强化时应考虑到SFT的可能性,PET/CT有助于恶性孤立性纤维瘤的诊断。更多还原

【Abstract】 Objective To explore CT,PET/CT imaging manifestations and pathological features of solitary fibrous tumor(SFT).Methods The CT,PET/CT imaging findings and pathological features of 13cases with SFT were analyzed retrospectively.All underwent CT and enhanced CT scan,of which two also underwent PET/CT.All the imaging and pathological findings were summaried.Results ① SFT were located in the chest(5/13),abdomen(8/13).The average tumor size was 7.8cm(3.3to 17.8cm).They were round or oval(8/13),irregular(5/13).Nine tumors had well-defined contours and 4tumors showed ill-defined contours;② CT plain scan:5cases showed homogeneous density and 8cases showed inhomogeneous density.Hemorrhagic foci were detected in 1case;③ On enhanced CT:10tumors showed geographic enhancement and several feeding vessels extended to the center of the tumors in the arterial phase,and continuous or progressive enhancement with patch or irregular non-enhanced areas in the venous phase.Three tumors were shown mild-to-moderate uneven enhancement in the arterial and venous phase;④ On PET/CT:two cases were positive on PET imaging.The maximal and minimal SUV value of the lesions was 3.3and 2.9.On delayed imaging the largest SUV value was 2.3;⑤ The main histological characteristics were admixed hyper-and hypocellular foci of proliferating spindled cells encompassed by collagenous stroma,and numerous thin-walled blood vessels with a staghorn configuration.Immunohistochemical manifestations:CD34,Vimentin,Bcl-2were positive.Conclusion The findings of SFT has certain characteris-tics.The possibility of SFT should be considered when a single soft tissue mass with sharp border,in homogeneous density is detected,especially with geographic enhancement and several feeding vessels extended to the center of the tumors in the arterial phase,maintaining enhancement in the venous phase.PET / CT is helpful to the diagnosis of malignant SFT.更多还原