Xiao Ying, Chen Jiaer, Jiang Sen, Chen Ruowei, Li Yangkang
Department of Radiology, Cancer Hospital of Shantou University Medical College, Shantou, China.
Department of Medical Imaging, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China.
Front Med (Lausanne). 2025 May 27;12:1604996. doi: 10.3389/fmed.2025.1604996. eCollection 2025.
Solitary fibrous tumor of the pleura (SFTP) is a rare neoplasm. Familiarity of its radiologic features may allow preoperative diagnosis and improve management of patients. However, radiological studies on the comparison of imaging findings between SFTP and other thoracic tumors are scarce. This study aims to evaluate the radiologic features of SFTP on biphasic contrast-enhanced computed tomography (CT) images with focus on the differential diagnosis.
The clinical data and CT images of 25 patients with pathologically proven SFTP and 42 patients with other types of thoracic tumors were retrospectively reviewed. Patient age, CT features including lesion size, shape, margin, precontrast density, intratumoral calcification, intratumoral vessel, enhancement degree, and blood supply were evaluated. Qualitative data were compared with Chi-square test and quantitative data were compared with -test. When the radiologic features appeared to be significant in the univariate analysis, multivariate analysis was performed for SFTP group using logistic regression model. The diagnostic performance was established using the area under the receiver operating characteristic (ROC) curve.
Five CT features, including tumor size, contour, intratumoral vessels, marked enhancement, and blood supply from pulmonary circulation of two groups differed significantly ( < 0.05). Moreover, blood supply from pulmonary circulation was identified as the independent signs of SFTP by multivariate logistic regression analysis. The area under the ROC curve was 0.744 ( < 0.05).
Solitary fibrous tumors of the pleura are often seen as large, well circumscribed masses with intense heterogeneous enhancement and multiple intratumoral vessels on CT images. For large tumors which are difficult to identify, carefully looking for the feeding artery from pulmonary circulation will be helpful to diagnose SFTP.
胸膜孤立性纤维瘤（SFTP）是一种罕见的肿瘤。熟悉其放射学特征有助于术前诊断并改善患者的治疗管理。然而，关于SFTP与其他胸部肿瘤影像学表现比较的放射学研究较少。本研究旨在评估双期对比增强计算机断层扫描（CT）图像上SFTP的放射学特征，重点是鉴别诊断。
回顾性分析25例经病理证实的SFTP患者和42例其他类型胸部肿瘤患者的临床资料及CT图像。评估患者年龄、CT特征，包括病变大小、形态、边缘、平扫密度、瘤内钙化、瘤内血管、强化程度和血供。定性数据采用卡方检验比较，定量数据采用t检验比较。当单因素分析中放射学特征具有显著意义时，对SFTP组使用逻辑回归模型进行多因素分析。使用受试者操作特征（ROC）曲线下面积确定诊断性能。
两组的五个CT特征，包括肿瘤大小、轮廓、瘤内血管、明显强化和肺循环供血存在显著差异（P<0.05）。此外，多因素逻辑回归分析确定肺循环供血是SFTP的独立征象。ROC曲线下面积为0.744（P<0.05）。
胸膜孤立性纤维瘤在CT图像上常表现为边界清晰的大肿块，强化不均匀且明显，瘤内有多个血管。对于难以鉴别的大肿瘤，仔细寻找肺循环供血动脉有助于诊断SFTP。
