摘要
目的探讨骨原发性软骨肉瘤少见病理亚型的病理及影像学特征,提高对其影像学诊断的认识。方法回顾性分析南方医科大学南方医院经手术病理证实的骨原发性少见病理亚型软骨肉瘤8例的X线、CT和MR表现,8例均行X线平片检查,其中4例同时行CT检查,6例同时行MR检查。结果(1)骨膜型3例,1例以宽基底与肱骨干相连,T_1 WI呈等低信号影,T_2 WI呈皂泡状混杂高信号影,增强扫描病灶周缘花环状强化及肿瘤内间隔线状、弓状样强化。(2)去分化型2例,髓腔均呈溶骨性骨质破坏,均见层状骨膜反应;CT清晰显示软组织肿块内的环状、棉絮状密度增高影;病灶呈长T1、T2信号改变,增强扫描肿瘤明显不均匀强化。(3)透明细胞型3例,2例呈轻中度膨胀性、溶骨性骨破坏;1例呈磨玻璃样膨胀性骨质破坏,并见层状骨膜反应;CT可清晰显示桡骨髓腔内的斑块状高密度影;肿瘤呈长T1、T2信号影,均未见典型皂泡状、扇贝样改变。结论骨原发性少见病理亚型软骨肉瘤的各种影像检查目的在于当肿瘤表现具有软骨肉瘤的某些影像特点时,能在诊断与鉴别诊断中提及某种亚型,对治疗与手术方案制定及预后评估有重要的临床指导作用。
Objective To explore the pathological and imaging features of rare pathological subtypes of primary osteosarcoma and to improve the understanding of its imaging diagnosis. Methods The X-ray, CT and MR manifestations of 8 cases of primary pathological subtype chondrosarcoma of bone confirmed by operation and pathology in Nanfang Hospital of Southern Medical University were retrospectively analyzed. All 8 cases underwent X-ray plain film examination, of which 4 cases underwent CT examination at the same time and 6 cases underwent MR examination at the same time. Results(1) There were 3 cases of periosteal type, 1 case was connected with humeral shaft with wide base, T1 WI showed equal low signal,T2 WI showed high-signal shadow of soapy-like mixed, enhanced circumferential ring of flowering lesion and intra-tumor interval. Bow-like reinforcement.(2)2 cases of dedifferentiation type, the medullary cavity was osteolytic bone destruction, and the lamellar periosteal reaction was seen. CT clearly showed a ring-shaped, cotton-like density increase in the soft tissue mass. The lesions showed long T1 and T2 signal changes, and the enhanced scan tumors showed significant uneven enhancement.(3)3 cases of clear cell type, 2 cases of mild to moderate swelling, osteolytic bone destruction;1 case of ground glasslike expansive bone destruction, and see layered periosteal reaction. CT can clearly show the plaque-like high-density shadow in the medullary cavity. The tumor showed long T1 and T2 signal, and no typical soapy or scallop-like changes were observed.Conclusion The purpose of various imaging examinations of primary pathological subtypes of chondrosarcoma of bone is to refer to certain subtypes in diagnosis and differential diagnosis when the tumors have some imaging characteristics of chondrosarcoma,which has important clinical guiding role in the formulation of treatment and operation plan and the evaluation of prognosis.
作者
周俊
赵亮
蔡裕兴
陈卫国
唐浩
ZHOU Jun;ZHAO Liang;CAI Yuxing;CHEN Weiguo;TANG Hao(Department of Radiology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)
出处
《疑难病杂志》
CAS
2019年第5期515-518,共4页
Chinese Journal of Difficult and Complicated Cases
基金
广州市产学研协同重大专项(201604020058)
