腹盆部孤立性纤维瘤的CT诊断与鉴别诊断

摘要

Objective:To study the CT features for solitary fibrous tumor (SFT) in the abdomen and pelvis and to improve the diagnostic accuracy.Methods:Fourteen patients with SFT were collected in our hospital from January,2011 to December,2015.Characteristic of images were analyzed and compared for 10 SFT,which located outside the abdominal organs with extragastrointestinal stromal tumors (EGIST),leiomyosarcoma,and schwannoma.Results:Necrosis and cystic formation were frequently present in SFT in the abdomen and pelvis.CE-CT showed serpentine vessels along the periphery,while pattern of enhancement was maplike inhomogeneous progressive.Comparing with the EGIST or schwannoma,the difference of CT value in non-contrast and the arterial phase were statistically significant (P＜0.05).The numbers of peritumoral circuity vessel were significantly different between SFT and EGIST (~=18.27,P＜0.008) or between SFT and schwannoma (x2=19.25,P＜0.008).Comparing with the leiomyosarcoma or schwannoma,SFT located outside the abdominal organs.We found that tumor necrosis rate was significantly different between SFT and leiomyoscarcoma (x2=8.00,P＜0.008).Conclusion:SFT in the abdomen and pelvis show certain CT characteristics.The CT value in noncontrast and at the arterial phase,tumor necrosis rate,and serpentine vessels along the periphery were pivotal in differentiating SFT from leiomyosarcoma,EGIST and schwannoma.%目的:分析腹盆部孤立性纤维瘤(solitary fibrosis tumor,SFT)的CT表现,提高诊断正确率.方法:分析2011年1月至2015年12月湘雅医院经病理证实的14例SFT的CT特征,并将10例腹盆部脏器外SFT与同时期10例腹盆部脏器外平滑肌肉瘤、28例神经鞘瘤及18例胃肠外间质瘤(extragastrointestinal stromal tumors,EGIST)的影像表现进行对比分析.结果:腹盆部SFT大多呈“地图样”不均匀渐进性强化,易液化坏死,瘤周常见迂曲血管.SFT分别与EGIST、神经鞘瘤对比,其平扫CT值、动脉期强化程度差异有统计学意义(P＜0.05);SFT分别与EGIST、平滑肌肉瘤对比,瘤周血管影出现率差异均有统计学意义(P＜0.008).SFT与平滑肌肉瘤液化坏死率分类差异有统计学意义(p＜0.008).结论:腹盆部SFT的CT表现有一定特征,平扫CT值及动脉期强化程度、坏死液化率、瘤周迂曲血管出现率对其与平滑肌肉瘤、神经鞘瘤及EGIST的鉴别诊断有一定价值.