Wang Xiao-Qiang, Zhou Qing, Li Shi-Ting, Liao Chen-Long, Zhang Hua, Zhang Bi-Yun
From the *Department of Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai; †Department of Medical Oncology, Jiangsu Provincial Cancer Hospital, Nanjing; ‡Department of Ultrasonography, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai; and §Department of Radiotherapy, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China.
J Comput Assist Tomogr. 2013 Sep-Oct;37(5):658-65. doi: 10.1097/RCT.0b013e3182a05687.
Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm originating in the central nervous system (CNS), with imaging features currently not well known. The purposes were to describe and characterize clinical features and imaging findings of CNS SFT.
We retrospectively reviewed computed tomographic (CT; n = 10) and magnetic resonance (MR) images (n = 18) of 22 patients with SFT (13 males and 9 females; mean, 47.6 years) with associated clinical records.
Each lesion was found as a solitary, well-defined mass, ranging in size from 12 to 70 mm (mean, 38 mm). The tumor shape was roundlike in 16 cases (72.7%) and irregular in 6 cases (27.2%). The cerebellopontine angle zone was the most affected area (n = 6). On precontrast CT scans, 10 cases showed predominantly hyperattenuation (n = 9) and isoattenuation (n = 1). No lesion contained calcification, and 2 cases showed bone invasions. All 18 tumors examined by MR imaging showed homogeneous hypointensive (n = 5) or isointensive (n = 7) signal intensity and heterogeneous mixed isointense and hypointense signal intensity (n = 6) on T1-weighted images, whereas most tumors were predominantly isointense (n = 13) and hypointense (n = 4) to the cortex on T2-weighted images; on postcontrast CT and MR images, enhancement was marked homogeneous (n = 10) or heterogeneous (n = 12). Fourteen tumors had thickening of the meninges adjacent to the tumor.
Although SFT is a rare neoplasm in the CNS, it should be considered in the differential diagnosis. The most affected area is the cerebellopontine angle zone. Solitary fibrous tumor tends to have some imaging features, such as high attenuation on CT, isointense to hypointense signal intensity on MR images, and marked enhancement.
孤立性纤维瘤(SFT)是一种起源于中枢神经系统(CNS)的罕见间叶性肿瘤,其影像学特征目前尚不明确。本研究旨在描述和分析CNS SFT的临床特征及影像学表现。
回顾性分析22例SFT患者(男13例,女9例;平均年龄47.6岁)的计算机断层扫描(CT;n = 10)及磁共振(MR)图像(n = 18),并结合相关临床记录。
所有病灶均表现为孤立性、边界清晰的肿块,大小为12至70 mm(平均38 mm)。肿瘤形态呈类圆形16例(72.7%),不规则形6例(27.2%)。桥小脑角区是最常受累部位(n = 6)。平扫CT上,10例主要表现为高密度(n = 9)及等密度(n = 1),无病灶含钙化,2例显示骨质侵犯。18例接受MR成像检查的肿瘤在T1加权像上表现为均匀低信号(n = 5)或等信号(n = 7)以及不均匀的等信号与低信号混合(n = 6),而在T2加权像上多数肿瘤相对于皮质主要表现为等信号(n = 13)及低信号(n = 4);增强CT及MR图像上,强化表现为明显均匀强化(n = 10)或不均匀强化(n = 12)。14例肿瘤邻近脑膜增厚。
尽管SFT在CNS中是一种罕见肿瘤,但在鉴别诊断时应予以考虑。最常受累部位是桥小脑角区。孤立性纤维瘤往往具有一些影像学特征,如CT上的高密度、MR图像上等信号至低信号强度以及明显强化。