颅内孤立性纤维性肿瘤的影像学特征及病理学对照分析

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Abstract Objective: To investigate the imaging and pathological characteristics of primary intracranial solitary fibrous tumor(ISFT). Methods: Eight patients with primary ISFT received operation in our hospital from January 2005 to December 2015. All of the tumors were confirmed by pathology. Six cases received CT scan(4 with enhancement). All the cases underwent gadolinium-enhanced MR. Results: The main clinical symptom was headache(5/8). All the 8 tumors were single, and most origined from supratentorial(6/8), close to the meninges. Diameter of the tumors ranged from 3～7 cm(4.5 cm on average). And the tumors are lobulated, round or irregular in shape. CT scan showed the tumors were mainly mixed cystic and solid(4/6). Varicose veins were visible within tumors with heterogeneous enhancement. MR scan showed clear margin, with or without mild peritumoral edema in most cases(5/8). T1WI showed the signal was mainly isointense to the white matter. T2WI showed the signal of tumors was heterogeneous, with clear boundary between high and low signal(5/8). Contrast-enhanced T1WI showed marked heterogeneous enhancement, and some of the foci of low T2WI signal intensities showed enhancement(4/8). Pathological results showed the tumor cells were mainly spindle shaped, with varying arrangement, and the area with densely or loosely arranged cells appeared alternately. Blood vessels were rich in the stroma, and collagen and myxoid were visible. Immunohistochemical results showed Vimentin was diffusely positive(8/8). CD34 was positive in 7 tumors, Bcl-2 in 6 and Ki-67 ranged 5%～20%. Pathology showed 4 were benign, 2 were low-grade malignant and 2 were borderline. Conclusion: ISFT is solitary, clearly marginal, supratentorial origined, and closely related to the meninges. Most of them are mixed cystic and solid, with significantly heterogeneous enhancement. The “yin and yang” sign and enhancement of low signal area in T2WI are characteristic. The diagnosis of ISFT should not only depend on the imaging. The combination of imaging, pathology and immunohistochemistry is necessary. In addition, some benign tumors may relapse, so it should be followed up regularly.

Key words： Neurofibroma Pathology Tomography, X-ray computed Magnetic resonance imaging

Received: 25 October 2016

PACS:	Ｒ739.41
	Ｒ730.264
	Ｒ814.42
	Ｒ445.2

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	WANG Chao
	WANG Xiao-ming

Cite this article:

WANG Chao,WANG Xiao-ming. Imaging features and pathological analysis of the intracranial solitary fibrous tumor[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2017, 28(6): 381-386.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2017/V28/I6/381

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