CT and MRI Diagnosis of Intracranial Solitary Fibrous Tumor: A Clinical Case Analysis
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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。Abstract: Intracranial solitary fibroma (ISFT) is a kind of mesenchymal tissue-derived spindle cell tumor. Patients’ disease progression vary according to the course and location of the tumor. Due to its rarity, radiologists and clinicians lack a comprehensive understanding of ISFT. Hence, the preoperative misdiagnosis rate is high. This case report describes a 52-year-old male patient with intracranial solitary fibroma who presented with headache and weakness of both lower extremities. He underwent radiological examination, including CT and MRI, and was diagnosed with acoustic neuroma. After postoperative pathological tissue biopsy, he was diagnosed with ISFT. He was reviewed one and a half years after surgery; there was no significant discomfort in addition to the paralysis of the left facial nerve and swelling of the left side of the face. This case report retrospectively analyzes the radiological scans and the clinical data of the patient to summarize the key CT and MRI features of ISFT, improving the accuracy of the preoperative diagnosis of this rare disease, and contributing to current knowledge of the precise treatment of ISFT.
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Key words:
- tomography /
- X-ray computed /
- magnetic resonance imaging /
- solitary fibrous tumors
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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
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