作　　者： ;

机构地区： 深圳市第二人民医院

出　　处： 《放射学实践》 2019年第12期1299-1303,共5页

摘　　要： 目的:探讨颅内孤立性纤维瘤/血管外皮瘤(SFT/HPC)的影像学特征及病理表现。方法:回顾性分析经病理证实的23例颅内SFT/HPC患者的CT、MRI表现及临床、病理资料。所有患者行MRI平扫及增强扫描,其中8例行MRS检查,6例行DTI检查;10例行CT平扫,其中2例行CT增强扫描。结果:男女患者例数比为12:11,中位年龄44岁。病灶位于幕上17例,幕下5例,幕上延伸至幕下1例;边缘呈不规则、分叶状18例,类圆形5例。10例行CT平扫,病灶均呈稍高密度,密度不均7例,邻近颅骨骨质受压吸收或破坏5例。2例行CT增强扫描,病灶均表现为不均匀明显强化。MR T 1WI上病灶呈不均匀等、低混杂信号17例,均匀低信号6例;T 2WI上呈高、低混杂信号20例,均匀稍高信号3例,4例囊变。14例存在不同程度的瘤周水肿,9例肿瘤内可见迂曲的流空血管影。增强扫描21例呈不均匀明显强化,2例呈均匀强化,可见“脑膜尾征”8例。23例中Ⅰ~Ⅲ级SFT/HPC分别为8、6和9例。主要病理表现为病灶内可见束状、编织状分布的梭形细胞,胶原纤维丰富;Ⅱ~Ⅲ级病灶内可见更多的肿瘤细胞和较少的胶原组织,部分伴有肥大细胞和“鹿角”样血管。免疫组化检查显示23例病灶内CD34、CD99、Bcl-2和STAT6均为阳性表达。结论:颅内SFT/HPC的影像学表现具有一定特征性,尤其是磁共振成像对本病的诊断和鉴别诊断具有重要价值。 Objective:To investigate the imaging features and pathological characteristics of intracranial solitary fibrous tumor/hemangiopericytoma(SFT/HPC).Methods:The pathological data and imaging features of 23 lesions with surgery and pathology proven intracranial SFT/HPC were retrospectively analyzed.Results:The lesions were located on supratentorial(n=17),infratentorial(n=5),supratentorial and infratentorial(n=1).Eighteen lesions were lobulated or irregular.And 5 lesions were oval.On plain CT scan,all lesions showed slightly high density,which 7 lesions were heteroge-neous.Five lesions showed destruction of skull.Two lesions showed inhomogeneously markedly enhanced following contrast injection.On T 1WI,lesions showed isointense or slight hypointense signals,which were homogeneous in 6 lesions and heterogeneous in 17 lesions.On T 2WI,lesions showed mixed hyperintense and hypointense signals in 20 cases,homogeneous hyperintense in 3 cases,and cystic degeneration in 4 cases,peritumoral edema in 14 cases,tortuous flow void blood vessels in 9 cases.All lesions showed marked enhancement following contrast injection,in which 21 cases showed heteroge-neous enhancement and 2 cases showed homogeneous enhancement,and 8 cases showed"dural tail sign".The number of SFT/HPC with WHO gradeⅠ~Ⅲwas 8,6 and 9,respectively.The pathological characteristics of SFT/HPC under the microscope showed that tumor cells were spindle cells with bunched and braided distribution and different proportions of collagenous fibers.GradeⅡ~Ⅲlesions appeared to have more tumor cells and less collagenous tissue with plump cells and"staghorn"vasculature.In immunohistochemistry,tumor tissue showed CD34(+),CD99(+),Bcl-2(+)and STAT-6(+).Conclusion:Intracranial SFT/HPC on imaging especially MRI has some characteristics;MRI is of great value in the diagnosis and differentiation of this disease.

关 键 词： 脑肿瘤 孤立性纤维瘤 血管外皮细胞瘤 磁共振成像 体层摄影术 线计算机 病理学

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