CAJ | 학술논문

目的探讨颅内孤立性纤维瘤(ISFT)的影像特征.方法回顾性分析经病理及免疫组织化学证实的10例ISFT患者的CT及MRI表现.所有患者均行MR平扫及增强扫描,其中4例行CT平扫.结果所有病例术前均误诊为脑膜瘤,5例位于幕上、4例位于幕下、1例同时生长于幕上及幕下.所有病变均起源于颅内硬脑膜,8例肿瘤边缘可见明显分叶或浅分叶.4例CT检查均呈稍高密度,1例压迫颅底骨质致骨质吸收.仅1例可见包膜点样钙化,所有病灶实质内均未见钙化.T1WI以等、稍高信号为主,4例病灶信号均匀、6例信号不均.T2WI 2例病灶呈均匀等信号及低信号,4例表现为等、稍高或低信号相间,2例合并囊变,2例可见稍高T2信号及低T2信号两部分,呈所谓“阴阳征”.增强扫描所有病灶均明显强化,8例强化不均匀,低T2信号区域可见明显强化,4例出现“脑膜尾征”.结论 ISFT影像表现具有一定特点,当脑外肿瘤明显分叶,T2WI信号不均,存在低T2信号区域并明显强化,“脑膜尾征”较少或轻,无颅骨增厚等征象时有助诊断,典型“阴阳征”提示孤立性纤维瘤可能性大.
목적 탐토로내고립성섬유류(ISFT)적영상특정.방법 회고성분석경병리급면역조직화학증실적10례ISFT환자적CT급MRI표현.소유환자균행MR평소급증강소묘,기중4례행CT평소.결과 소유병례술전균오진위뇌막류,5례위우막상、4례위우막하、1례동시생장우막상급막하.소유병변균기원우로내경뇌막,8례종류변연가견명현분협혹천분협.4례CT검사균정초고밀도,1례압박로저골질치골질흡수.부1례가견포막점양개화,소유병조실질내균미견개화.T1WI이등、초고신호위주,4례병조신호균균、6례신호불균.T2WI 2례병조정균균등신호급저신호,4례표현위등、초고혹저신호상간,2례합병낭변,2례가견초고T2신호급저T2신호량부분,정소위“음양정”.증강소묘소유병조균명현강화,8례강화불균균,저T2신호구역가견명현강화,4례출현“뇌막미정”.결론 ISFT영상표현구유일정특점,당뇌외종류명현분협,T2WI신호불균,존재저T2신호구역병명현강화,“뇌막미정”교소혹경,무로골증후등정상시유조진단,전형“음양정”제시고립성섬유류가능성대.
Objective To summarize the imaging features of intracranial solitary fibrous tumors (ISFT).Methods Ten patients with ISFT proven histopathologically were collected.Four cases had CT data and all cases had MR data.The imaging features and pathological results were retrospectively analyzed.Results All cases were misdiagnosed as meningioma at pre-operation.All lesions arose from intracranial meninges including 5 lesions above the tentorium,4 lesions beneath the tentorium and 1lesion growing around the tentorium.The margins of all the masses were well defined,and 8 lesions presented multilobular shape.CT demonstrated hyerattenuated masses in all 4 lesions,smooth erosion of the basicranial skull in 1lesion,and punctiform calcification of the capsule in 1lesion.T1WI showed most lesions with isointense or slight hyperintense signals including homogeneous in 4 lesions and heterogeneous in 6 lesions.T2WI demonstrated isointense or slight hyperintense in 2 lesions,mixed hypointense and hyperintense signals in 4,cystic portion in 2,and two distinct portion of hyperintense and hypointense signal,so called “yin-yang”pattern,in 2.Strong enhanced was found in all lesions,especially in 8 lesion with heterogeneous with the low T2 signal.“Dural tail” was found in 4 lesions.Conclusions ISFI has some specific CT and MR features including heterogeneous signal intensity on T2WI,strong enhancement of areas with low T2 signal intensity,slight or no “dural tail”,without skull thickening,and the typical “yin-yang” pattern.