【摘要】 目的分析良、恶性眼眶孤立性纤维瘤(SFT)常规MRI图像和DWI特点,提高本病的认识。方法回顾性分析29例病理证实的眼眶SFT的MRI平扫、增强和DWI特点,测量病灶实质部分的平均表观扩散系数(mean apparent diffusion coefficient,ADCmean)值进行统计学分析。结果良性SFT组14例,恶性SFT组15例,边界均较清,仅3例恶性者与临近外直肌粘连。良恶性SFT在T1WI均以等稍低信号为主; T2WI稍高信号(共15例内伴低信号影);增强后所有病灶均明显强化,3例良性SFT及4例恶性SFT呈类血管样显著强化; 13例病灶(7例恶性,6例良性)周围有血管流空影。DWI良性组的ADCmean均值为1.10±0.26 (×10-3mm~2/s),明显高于恶性组的ADCmean均值为0.92±0.29 (×10-3mm~2/s)。结论良性SFT与恶性SFT在常规MRI序列上缺乏特异性表现,联合ADCmean值有助于二者鉴别诊断。更多还原

【Abstract】 Objective To improve the diagnostic accuracy of benign and malignant orbital solitary fibrous tumor( SFT) by using conventional MRI images and the diffusion weighted imaging( DWI). Methods MRI manifestations of 29 patients with SFT confirmed by pathology were retrospectively analyzed,including enhanced MRI and diffusion weighted imaging( DWI) before surgery. The mean apparent diffusion coefficient( ADCmean) were collected. Results There were 14 benign SFTs and 15 malignant SFTs. The boundaries of all were clear,with the exception of 3 cases,showing adhesion to the adjacent lateral rectus muscle. Of all the benign and malignant cases,most cases showed isointensity or slightly hypo intensity on T1 WI and slightly hyper intensity on T2 WI,the areas of hypo intensity were observed in totally 15 cases on T2 WI. 13 cases( 7 malignant SFTs and 6 benign SFTs) had vascular flow around the lesion,All lesions were significantly enhanced after enhancement. 3 cases of benign SFTs and 4 cases of malignant SFTs showed vascular-like enhancement. The average ADCmean value of benign SFTs was 0. 80 ±0. 29( × 10-3 mm~2/s),significantly higher than that of malignant SFTs [0. 92 ± 0. 29( × 10-3 mm~2/s) ]. Conclusion Conventional MRI manifestations of benign and malignant SFTs are lack of specificity,ADCmean value is helpful in differential diagnosis.更多还原