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CT与MRI诊断颅内孤立性纤维瘤临床案例分析

闫昕 赵建华

闫昕, 赵建华. CT与MRI诊断颅内孤立性纤维瘤临床案例分析[J]. CT理论与应用研究, 2023, 32(0): 1-6. DOI: 10.15953/j.ctta.2023.126
引用本文: 闫昕, 赵建华. CT与MRI诊断颅内孤立性纤维瘤临床案例分析[J]. CT理论与应用研究, 2023, 32(0): 1-6. DOI: 10.15953/j.ctta.2023.126
YAN X, ZHAO J H. CT and MRI Diagnosis of Intracranial Solitary Fibrous Tumor: A Clinical Case Analysis[J]. CT Theory and Applications, 2023, 32(0): 1-6. DOI: 10.15953/j.ctta.2023.126. (in Chinese)
Citation: YAN X, ZHAO J H. CT and MRI Diagnosis of Intracranial Solitary Fibrous Tumor: A Clinical Case Analysis[J]. CT Theory and Applications, 2023, 32(0): 1-6. DOI: 10.15953/j.ctta.2023.126. (in Chinese)

CT与MRI诊断颅内孤立性纤维瘤临床案例分析

doi: 10.15953/j.ctta.2023.126
详细信息
    作者简介:

    闫昕:女,内蒙古医科大学在读研究生,主要从事神经系统影像研究,E-mail:1971554233@qq.com

    通讯作者:

    男,内蒙古自治区人民医院影像医学科副主任医师、硕士生导师,E-mail:zjh2822yyjh@163.com

CT and MRI Diagnosis of Intracranial Solitary Fibrous Tumor: A Clinical Case Analysis

  • 摘要: 颅内孤立性纤维瘤(ISFT)是一种间叶组织来源的梭形细胞肿瘤,临床表现依据病程和肿瘤发生部位不同表现各异,发病罕见,影像及临床医生对其缺乏全面认识,术前误诊率高。本文报告1例颅内孤立性纤维瘤病例,52岁男性,临床表现为头痛及双下肢无力;CT及MRI影像学检查诊断为左侧听神经瘤。后经术后病理组织活检确诊为ISFT。患者术后1年半复查,左侧面神经麻痹,左侧面部憋胀,余无明显不适。本文回顾性分析该患者的影像学表现及临床资料,旨在总结出此种罕见病的CT及MRI影像表现,以提高医生的术前诊断准确率,为临床精准治疗提供重要的帮助。

     

  • 图  1  ISFT患者CT平扫图像

    图(a)~(b):轴位CT平扫示左侧桥小脑角区片状低密度影(红箭),周围水肿明显,左侧内听道扩大(蓝箭)。

    Figure  1.  CT plain scan of the patient with ISFT

    图  2  ISFT患者MRI平扫及增强图像

    图(a)~(c):MRI平扫示左侧桥小脑角区听神经根部大小约4.3㎝×5.9㎝×4.8㎝囊实性混杂信号影(红箭),实性部分T1 WI(a)、T2 WI(b)呈混杂信号,边界清晰,边缘欠规整,DWI(c)呈混杂信号,听神经增粗,左侧内听道扩大,邻近脑实质及第4脑室受压推移,瘤周水肿明显,并可见流空血管影;图(d)~(g):增强扫描图像,(d)和(e)为轴位,(f)和(g)分别为矢状位和冠状位,肿瘤实性成分呈不均匀明显持续性强化(红箭),窄基底与硬脑膜相连,T2 WI低信号区强化明显。

    Figure  2.  MRI plain and contrast-enhanced images of the patient with ISFT

    图  3  ISFT患者术后病理图像

    图(a)~(b):镜下肿瘤细胞呈梭形,稀疏区与密集区交替分布(HE,×200)。

    Figure  3.  Postoperative pathological images of the patient with ISFT

  • [1] CARNEIRO S S, SCHEITHAUER B W, NASCIMENTO A G, et al. Solitary fibrous tumor of the meninges: A lesion distinct from fibrous meningioma. A clinicopathologic and immunohistochemical study[J]. American Journal of Clinical Pathology, 1996, 106(2): 217−224. DOI: 10.1093/ajcp/106.2.217.
    [2] LOUIS D N, PERRY A, WESSELING P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: A summary[J]. Neuro-Oncology, 2021, 23(8): 1231−1251. DOI: 10.1093/neuonc/noab106.
    [3] 吴虹林, 苏伟杰, 李西西, 等. 中枢神经系统孤立性纤维瘤临床特征及术后复发因素[J]. 中国神经精神疾病杂志, 2023,49(2): 85−91. doi: 10.3969/j.issn.1002-0152.2023.02.003
    [4] MIETTINEN M M, EL-RIFAI W, SARLOMO-RIKALA M, et al. Tumor size-related DNA copy number changes occur in solitary fibrous tumors but not in hemangiopericytomas[J]. Modern Pathology, 1997, 10(12): 1194−1200.
    [5] FARGEN K M, OPALACH K J, WAKEFIELD D, et al. The central nervous system solitary fibrous tumor: a review of clinical, imaging and pathologic findings among all reported cases from 1996 to 2010[J]. Clinical Neurology and Neurosurgy, 2011, 113(9): 703−710. DOI: 10.1016/j.clineuro.2011.07.024.
    [6] 高文华, 黄玉芳, 朱小贵, 等. 颅内孤立性纤维瘤影像表现[J]. 现代医用影像学, 2019,28(7): 1472−1474. doi: 10.3969/j.issn.1006-7035.2019.07.005

    GAO W H, HUANG Y F, ZHU X G et al. Imaging Characters of Intracranial Solitary Fibrous Tumor[J]. Modern Medical Imageology, 2019, 28(7): 1472−1474. (in Chinese). doi: 10.3969/j.issn.1006-7035.2019.07.005
    [7] 梅磊磊, 聂蕾, 唐文英, 等. 孤立性纤维瘤的影像表现及临床病理特征[J]. 放射学实践, 2022,37(5): 566−570. DOI: 10.13609/j.cnki.1000-0313.2022.05.006.

    MEI L L, NIE L, TANG W Y, et al. Imaging and clinicopathologic features of solitary fibrous tumor[J]. Radiologic Practice, 2022, 37(5): 566−570. DOI: 10.13609/j.cnki.1000-0313.2022.05.006. (in Chinese).
    [8] 曾禹莉, 易熙, 赵洁, 等. 颅内孤立性纤维瘤的CT及MRI表现[J]. 影像研究与医学应用, 2022,6(4): 163−165. doi: 10.3969/j.issn.2096-3807.2022.04.055
    [9] CLARENCON F, BONNEVILLE F, ROUSSEAU A, et al. Intracranial solitary fibrous tumor: imaging findings[J]. European Journal of Radiology, 2011, 80(2): 387−394. DOI: 10.1016/j.ejrad.2010.02.016.
    [10] 何文杰, 雷益, 焦娟, 等. 颅内孤立性纤维瘤/血管外皮瘤的影像表现与病理分析[J]. 放射学实践, 2019,34(12): 1299−1303. DOI: 10.13609/j.cnki.1000-0313.2019.12.004.

    HE W J, LEI Y, JIAO J, et al. Imaging features and pathological analysis of intracranial solitary fibrous tumor/hemangiopericytoma[J]. Radiologic Practice, 2019, 34(12): 1299−1303. DOI: 10.13609/j.cnki.1000-0313.2019.12.004. (in Chinese).
    [11] 冯加和, 杨云竣, 杨粤龙, 等. 颅内孤立性纤维瘤/血管外皮瘤瘤内血管流空特征研究[J]. 医学影像学杂志, 2022,32(8): 1273−1276. doi: 10.3969/j.issn.1006-9011.2022.8.yxyxxzz202208002

    FENG J H, YANG Y J, YANG Y L, et al. Study on the characteristics of intratumoral vascular flow void in solitary fibrous tumor / hemangiopericytoma[J]. Journal of Medical Imaging, 2022, 32(8): 1273−1276. (in Chinese). doi: 10.3969/j.issn.1006-9011.2022.8.yxyxxzz202208002
    [12] 张宇泽, 杨云竣, 陈静勿, 等. 血管瘤型脑膜瘤与颅内孤立性纤维瘤的MRI征象分析[J]. 临床放射学杂志, 2022,41(11): 2010−2014. DOI: 10.13437/j.cnki.jcr.2022.11.007.

    ZHANG Y Z, YANG Y J, CHEN J W, et al. A Comparative Study on MRI Signs between Angiomatous Meningioma and Solitary Fibrous Tumor[J]. Journal of Clinical Radiology, 2022, 41(11): 2010−2014. DOI: 10.13437/j.cnki.jcr.2022.11.007. (in Chinese).
    [13] 陶静雄, 梁奕, 王佳, 等. 颅内孤立性纤维瘤的影像学和病理学特征[J]. 医学影像学杂志, 2019,29(11): 1976−1978.

    TAO J X, LIANG Y, WANG J, et al. Imaging and pathological features of intracranial solitary fibrous tumor[J]. Journal of Medical Imaging, 2019, 29(11): 1976−1978. (in Chinese).
    [14] 柯代波, 刘文科, 张思, 等. 颅内孤立性纤维瘤的MRI表现[J]. 华西医学, 2017,32(1): 46−50. DOI: 10.7507/1002-0179.201511166.

    KE D B, LIU W K, ZHANG S, et al. MRI manifestations of intracranial solitary fibrous tumor[J]. West China Medical Journal, 2017, 32(1): 46−50. DOI: 10.7507/1002-0179.201511166. (in Chinese).
    [15] DOYLE L A, VIVERO M, FLETCHER C D, et al. Nuclear expression of STAT6 distinguishes solitary fibrous tumor from histologic mimics[J]. Modern Pathology, 2014, 27(3): 390−395. DOI: 10.1038/modpathol.2013.164.
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出版历程
  • 收稿日期:  2023-06-12
  • 修回日期:  2023-07-27
  • 录用日期:  2023-08-02
  • 网络出版日期:  2023-09-07

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