Li Xueming, Ren Jing, Zhou Peng, Cao Ying, Cheng Zhuzhong, Yu Jianqun, Xu Guohui
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2015 Feb;32(1):157-62.
In order to investigate the features of multidetector CT (MDCT) and magnetic resonance imaging (MRI) as well as the corresponding pathogic basis of solitary fibrous tumor (SFT) in the pelvis, we collected the clinical data of 13 patients with pathologically confirmed SFT in pelvis, and retrospectively reviewed the MDCT and MRI appearances. Of these enrolled patients, 6 received MDCT scans, 5 underwent MRI scans, and 2 underwent both MDCT and MRI examinations. Shown on the MDCT and MRI, the maximum diameters of the masses ranged from 4.0 to 25.2 cm (averaged 11.8 cm). Six masses were lobulated, and seven were round or oval. In addition, all masses were well-defined and displaced the adjacent structures to some degrees. On the computed tomography, all masses were of isodensity on unenhanced scans in general, among which five masses were demonstrated with hypodense areas. On the MRI T1-weighted image, all lesions were isointense, of which patchy hypointense areas were detected in 3 cases and radial hypointense areas were in 3 cases, and the other one was presented with homogenous intensity. On T2-weighted images, most of the lesions were mixed hyperintense, of which 3 cases were of heterogenous hyperintesity, radial hypointense areas were detected in 3 patients, and the other one was homogenously intense. On enhanced computed tomography and MRI, large supplying vessels were found in 4 cases; 12 cases showed moderate to conspicuous enhancement, and the other one was presented with mild homogenous enhancement. Of the patients with moderate to conspicuous enhancement, patchy areas of non-enhancement were detected in 7 cases, radial areas of progressive enhancement were detected in 3 cases, and the remained 2 cases showed homogenous enhancement. On pathology, the radial area presented as progressive enhancement was fibrosis. During the follow-ups after surgery, 2 patients had local recurrence and 1 had metastasis to liver. In conclusion, the SFT in the pelvis are commonly presented as a large solid, well-defined and hypervascular mass with necrosis or cystic changes at some extents together with the displacement of adjacent structures. The radial area with hypointensity on T2-weighted image and with progressive enhancement on enhanced magnetic resonance imaging is an important feature of SFT, which can be helpful for the diagnosis of this mass.
为了探讨多层螺旋CT(MDCT)和磁共振成像(MRI)表现以及盆腔孤立性纤维瘤(SFT)相应的病理基础,我们收集了13例经病理证实的盆腔SFT患者的临床资料,并回顾性分析其MDCT和MRI表现。在这些入选患者中,6例行MDCT扫描,5例行MRI扫描,2例行MDCT和MRI检查。MDCT和MRI显示,肿块最大径4.0~25.2 cm(平均11.8 cm)。6个肿块呈分叶状,7个为圆形或椭圆形。此外,所有肿块边界清晰,不同程度地推移相邻结构。CT平扫时,所有肿块密度一般均匀,其中5个肿块可见低密度区。MRI T1加权像上,所有病灶信号均匀,3例可见斑片状低信号区,3例可见放射状低信号区,另1例信号均匀。T2加权像上,多数病灶呈混合高信号,其中3例信号不均匀,3例可见放射状低信号区,另1例信号均匀。增强CT和MRI显示,4例可见粗大供血血管;12例呈中度至明显强化,另1例呈轻度均匀强化。在中度至明显强化的患者中,7例可见斑片状无强化区,3例可见放射状渐进性强化区,其余2例呈均匀强化。病理上,呈渐进性强化的放射状区域为纤维化。术后随访期间,2例局部复发,1例肝转移。总之,盆腔SFT通常表现为较大的实性、边界清晰、富血管肿块,部分有坏死或囊变,推移相邻结构。T2加权像上呈低信号、增强MRI呈渐进性强化的放射状区域是SFT的重要特征,有助于对此类肿块的诊断。