| Summary: | Objective To investigate the CT and MRI findings of systemic solitary fibrous tumors (SFTs) in order to improve their recognition. Methods Thirty-three patients with pathologically confirmed SFTs in pleural and extrapleural areas admitted in our hospital from January 2013 to April 2018 were enrolled in this study. Among them, 25 underwent CT scanning, 15 received MRI scanning, and 7 underwent both examinations. Their clinicopathological data and imaging features were collected and retrospectively analyzed. Results The tumor masses were located in the head and neck, chest and back, abdominopelvic cavity and soft tissues of the extremities in the 33 patients. On the CT images, the tumors appeared iso- to slightly hypoattenuated masses. While, on the MRI images, the majority of the tumors showed iso- to hypointensity on T1WI, and isodensity, slightly hyperintensity or a pattern of mixed hyper- and hypointensity on T2WI. On diffusion weighted image (DWI), 8 cases were found to be iso- to hypointense, and 2 cases were iso- to hypointense with patchy hyperintensity. After injection of a contrast agent, 25 of the 32 cases demonstrated obviously intense enhancement and 7 cases were slightly to moderately enhanced on contrast-enhanced images, all of which persisted in the delayed phase. Twenty of the 25 cases showed consistently map-like enhancement, and 4 and 1 cases being heterogeneously and homogeneously enhanced, respectively. In addition, multiple big and small vessels were found on the contrast-enhanced images in 19 cases. Conclusion SFTs always persist in the delayed phase, most of which demonstrate map-like enhancement or heterogeneously persistent enhancement, while a few show homogeneous or slight to moderate persistent enhancement on contrast-enhanced images. Notably, image findings including masses with thick, or dotted and stripped blood vessels, iso- to hypointensity on DWI, and increased apparent diffusion coefficient (ADC) values are of great value for preoperative diagnosis of SFTs.
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