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探讨CT对良恶性胸膜孤立性纤维性肿瘤鉴别的诊断价值 被引量:26

CT evaluation of benign and malignant solitary fibrous tumor of the pleura
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摘要 目的分析胸膜良恶性孤立性纤维性肿瘤的CT表现,探讨可以鉴别其良恶性的cT征象,用于指导临床治疗。方法回顾性分析经病理证实的20例良性、11例恶性胸膜孤立性纤维性肿瘤的cT特点,分析2组病灶的大小、边界、内部特点、血供情况、对邻近结构的侵犯、是否合并转移或胸腔积液。对肿瘤大小行单因素方差分析,其他征象利用Fisher精确检验进行统计学分析。结果31例肿瘤中,恶性组孤立性纤维性肿瘤的大小(中位值13.5cm)明显高于良性组(中位值7.6em;F=6.411,P=0.017),密度多不均匀(恶性9例、良性4例,P=0.002),肿瘤内部更易出现迂曲肿瘤血管影(恶性10例、良性8例,P=0.008),更容易侵犯邻近结构(恶性6例、良性0例,P=0.001)或转移(恶性2例、良性0例)及合并胸腔积液(恶性6例、良性3例,P=0.038),钙化(恶性2例、良性2例)在2组中差异无统计学意义(P=0.6);12例(良性4例,恶性8例)3DcT血管成像可发现肿瘤主要的血供来源于壁层胸膜的供血血管。结论CT及3DCT血管成像有助于鉴别胸膜良恶性孤立性纤维性肿瘤,并显示肿瘤的血供来源,对术前评估可切除性方面具有一定的临床应用价值。 Objective To analyze CT findings of solitary fibrous tumors of the pleura (SFTP) for differentiating benign and malignant lesions. Methods CT findings of 20 benign and 11 malignant SFTPs proved by pathology were retrospectively reviewed. The size, margin, internal structures, blood supplies, invasion to adjacent structures or metastasis and pleural effusion were analyzed and compared between malignant and benign groups. Results The mean diameter of malignant lesions ( median diameter: 13.5 cm) was larger than that of the benign ( median diameter: 7.6 cm, F = 6. 411, P = 0. 017 ). Malignant lesions tended to be more heterogeneous (9/11, P = 0. 002), more invasive to adjacent structures (6/11, P = 0. 001 ) than benign lesions ( 4/20, 0/20 ). Serpiginous vessels ( 10/11, P = 0. 008 ) and pleural effusion (6/11, P = 0. 038 ) were more common in malignant lesions than those in benign lesions (8/20,3/20). Calcification could be found in both benign (2/20) and malignant lesions (2/11, P = 0. 6). Furthermore, 3D CT angiography could show blood supplies into tumor in 12 lesions (4 benign and 8 malignant SFTPs). Conclusion CT and 3D CTA are helpful in differentiating benign from malignant SFTPs and evaluating the excision of SFTPs.
出处 《中华放射学杂志》 CAS CSCD 北大核心 2012年第9期789-792,共4页 Chinese Journal of Radiology
关键词 胸膜肿瘤 纤维性肿瘤 体层摄影术 X线计算机 血管造影术 Pleural neoplasms Fibroma Tomography, X-ray computed Angiography
作者简介 通信作者:梁长虹,Email:cjr.lchh@vip.163.com
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参考文献22

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二级参考文献25

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