摘要
目的探讨少见部位骨肉瘤的影像学表现,以提高对本病的认识。方法回顾性分析经病理证实的13例少见部位骨肉瘤的临床病例资料及影像学表现,结合文献总结其临床及影像学表现。全部13例患者行X线平片和CT检查,其中7例行CT增强扫描,8例行MRI检查,其中6例行MRI动态增强检查。结果肿瘤发生于骨盆4例,上颌骨3例,肩胛骨2例,胫骨干1例,胫骨远端1例,跟骨1例,尺骨干1例。影像表现为溶骨型6例,成骨型5例,混合型2例。出现广泛骨质破坏9例,骨膜反应2例,软组织肿块9例,瘤骨或肿瘤样钙化11例。CT较X线能更直观地显示病变位置及其与毗邻结构关系,在显示骨质破坏、骨膜反应及瘤骨和瘤样钙化方面具有较大优势。MRI在判断肿瘤的位置、大小、累及范围方面较CT有优势,能清晰显示髓腔及周围软组织的侵犯蔓延程度、软组织肿块的形成。结论少见部位的骨肉瘤多发生于中老年人患者,影像学表现以溶骨型骨肉瘤较为多见,病灶内出现瘤骨或肿瘤样钙化是诊断的关键,X线、CT和MRI三者结合有助于本病的诊断与鉴别诊断。
Objective To explore the imaging features of X-ray,CT and MRI of osteosarcoma in unusual sites.Methods The clinical data and imaging findings of 13 cases of unusual site osteosarcoma confirmed by pathology were retrospectively analyzed,and the clinical and imaging findings were summarized according to the literature.All of the 13 patients were examined by X-ray and CT,in which seven cases underwent contrast-enhanced CT,eight cases underwent MRI,and six cases underwent contrast-enhanced MRI.Results Tumors occurred in the pelvis in 4 cases,3 in maxilla,2 in scapula,2 in tibia,1 in distal tibia,and 1 in calcaneus,and 1 in ulna.Six cases were osteolytic lesions,5 cases were osteoblastic,and 2 cases were mixed.Large bone destruction was present in 9 cases,periosteal reaction was present in 2 cases,soft tissue mass was present in 9 cases,and neoplastic bone or tumor calcification were present in 11 cases.Compared with X ray,CT could more directly display the location of the lesion and its relationship with adjacent structures.This kind of medical image also had great advantages in displaying the bone destruction,periosteal reaction,tumorous bones and tumor-like calcification.MRI had advantages over CT in judging the location,size and extent of tumor.Moreover,it coud clearly show the extent of invasion,the spread of medullary cavity and surrounding soft tissues,and the formation of soft tissue mass.Conclusion Most osteosarcoma in unusual sites occur in older persons.Frequently the lesions are osteolytic in imaging.It is critical to find neoplastic bone and tumor calcification in the lesion.The combination of X-ray,CT and MRI can help to diagnose and differentiate this lesion.
作者
李睿弢
刘峰
赵松波
岳振营
田昭俭
LI Ruitao;LIU Feng;ZHAO Songbo;YUE Zhenying;TIAN Zhaojian(Department of Radiology,Shengli Oilfield Central Hospital,Dongying 257034,Shandong,China;Department of Pathology,Shengli Oilfield Central Hospital,Dongying 257034,Shandong,China)
出处
《滨州医学院学报》
2024年第1期55-60,共6页
Journal of Binzhou Medical University
基金
国家临床重点专科基金【国卫办医函(2018)292号】。
关键词
骨肿瘤
骨肉瘤
体层摄影术
X线计算机
磁共振成像
bone neoplasmas
osteosarcoma
tomograpy
x-ray computer
magnetic resonance imaging
