原发性软骨肉瘤影像学表现与病理关系.pdfVIP

62 放射学实践2008年1月第23卷第1期 Radiol Practice，Jan 2008，Vol 23，No．1 原发性软骨肉瘤影像学表现与病理关系 骨骼肌肉影像学 周建军，丁建国，曾蒙苏，王建华，周康荣，程伟中 【摘要】 目的：探讨软骨肉瘤的CT和 MR及其增强表现，分析其病理基础。方法：回顾分析经手术病理证实的软骨 肉瘤27例，术前分别或同时经X线平片、CT平扫和增强、MR SE T WI、T WI和 T，WI增强扫描，复习影像学扫描结果 并和手术病理作对照。结果：27例软骨肉瘤中，普通型22例，间充质型3例，去分化型2例。发病部位包括骨盆 11例，管 状骨10例，肋骨2例，胸骨 1例，椎体 1例，软组织 1例，腹膜后 1例。肿瘤直径4．5～23．0 cm，5．0 cm 2例，5．0～ 10．0 C1TI 17例，10．0 cm 8例。骨质破坏呈轻度膨胀性或溶骨性，密度等于或低于肌肉密度，钙化21例，扇贝状分叶边缘 19例，骨膜增生3例。肿瘤CT值等于或低于肌肉；MR T wI呈等低信号，T wI为显著高信号，高信号内总见弓环状低 信号分隔或低信号结节。CT和MR增强13例，小叶分隔呈环弓状进行性持续强化，小叶自身不强化。结论：扇贝状分叶 边缘、弓环状钙化、TzwI显著高信号内存在弓环状低信号、弓环状进行性强化等构成各型软骨肉瘤的特异性影像学特征， 对诊断具有重要价值。 【关键词】 软骨肉瘤；体层摄影术，x线计算机；磁共振成像；病理学 【中图分类号】R738．3；R445．2；R814．42 【文献标识码】A 【文章编号】1000—0313(2008)01—0062—04 Imaging Findings of Primary Chondrosarcoma Correlated with Pathology Findings ZHOU Jian—jun，DING Jian—guo，ZHOU Kang—rong，et a1．Department of Radiology，Zhongshan Hospital，Fudan University，Shanghai 200032，P．R．China [Abstract] Objective：To study the CT and MRI features(without and with contrast enhancement)of primary chon— drosareoma and correlated with their pathology basis．Methods：27 patients with surgery and pathology proved primary chon— drosarcoma underwent radiography，spiral CT with and without contrast administration and MR1 were performed before surgery．The MRI sequences included SE T1 WI，FSE T2 WI and SE Tl WI after contrast enhancement．The imaging materials were reviewed and analyzed retrospectively and correlated with surgical and pathological results．Results：Of the 27 patients，the pathology classification included conventional chondrosarcoma(n一22)，mesenchymal chondrosarcoma(n一3) and dedifferentiated chondrosarcoma(n一2)．The location of tumor included pelvis(n一11)，long bone(n-=10)，rib(n一 2)，sternum，vertebral body，soft tissue and retroperitoneum (n一1 each