摘要
目的 探讨骨外周性原始神经外胚层瘤 (pPNETs)的临床和影像学表现。方法 分析 10例骨pPNETs的临床和X线、CT及MR影像资料。结果 pPNETs多以局部疼痛 (9例 )伴肿块 (7例 )为主诉。X线示溶骨性骨质破坏 8例 ,伴有不规则硬化和轻度膨胀的溶骨性骨质破坏 1例 ,未见异常 1例 ;7例见软组织肿块 ;均未见骨膜反应。 7例CT扫描中 ,边界不清的溶骨性骨质破坏 6例 ,伴有不规则硬化和轻度膨胀的溶骨性骨质破坏 1例 ,均有软组织肿块形成 ,2例伴有细小的点状钙化 ,均未见骨膜反应 ;10例MR扫描中 ,9例在T1WI呈等信号 ,1例呈中等偏高信号 ;在T2 WI和短时反转恢复(STIR)序列 ,8例呈不均匀中、高信号 ,2例呈均匀高信号 ;均见明显软组织肿块形成 ;4个疗程化疗以后 ,肿瘤有明显缩小。结论 骨pPNETs以溶骨性骨质破坏伴明显的软组织肿块、无骨膜反应为主要表现 ,缺乏特征性 ,但影像学检查有助于了解病变的范围、治疗措施的制定和治疗效果的评价。
Objective To describe the clinical and imaging features of peripheral primitive neuroectodermal tumors (pPNETs) of the bone.Methods The clinical data, plain films, and CT and MR images in 10 patients with pathologically proved pPNETs were reviewed retrospectively.Results The age at diagnosis ranged from 8 years to 68 years (mean 24.4 years). The clinical presentations of most cases were local pain (9/10) with a mass grew quickly (7/10). The X-ray findings were lytic lesion (8 cases), lytic lesion with irregular sclerosis and dilation (1 case), and normal (1 case). Soft tissue mass was present in 7 cases. No case had periosteal reaction. CT scan was performed in 7 cases, and the CT findings included lytic lesion (6 cases), lytic lesion with irregular sclerosis and dilation (1 case), soft tissue mass (7 cases), speculate calcification (2 cases), and no periosteal reaction. MRI was conducted in 10 cases. Isointensity (9 cases) and slight hyperintensity (1 case) were demonstrated on T 1WI, and heterogeneous iso- or hyperintensity (8 cases) and homogeneous hyperintensity (2 cases) on T 2WI and STIR images. Large mass was detected in all the cases. In 5 cases with contrast enhancement, moderate enhancement was present in 2 cases, and marked heterogeneous enhancement in 3 cases. After 4 courses of chemotherapy in 4 cases, the size of the lesions decreased markedly.Conclusion Most cases of pPNETs were in patients under 30 years, the clinical presentations were local pain with a mass that grows quickly. The imaging features of pPNETs were a destructive lesion with a massive soft tissue mass without periosteal reaction. The imaging is useful in delineating the extent of tumor and monitoring treatment, although the imaging findings are nonspecific.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2004年第11期1141-1146,共6页
Chinese Journal of Radiology
