尤文氏肉瘤的影像学表现.pdfVIP

Jennifer Son, Year III Gillian Lieberman, MD Imaging of Ewing’s Sarcoma Jen Son Harvard Medical School BIDMC, Boston Gillian Lieberman, MD Jennifer Son, Year III Gillian Lieberman, MD Our Patient PA Chest film 6 yo female presents with right clavicular mass and pain Area of mottled sclerosis and lucency in the distal half of the right clavicle, slightly expansive Lesion borders are ill-defined with associated periosteal reaction and cortical thinning Associated soft tissue mass, normal contour lost Lesion concerning for malignancy—MRI recommended Jennifer Son, Year III Gillian Lieberman, MD MRI Suspicion of malignancy -provides information on marrow and soft tissue involvement—spread through medullary better seen than on plain radiographs; can detect presence of skip lesions in bone -must be obtained before biopsy because postoperative changes can confuse true extent of disease Jennifer Son, Year III Gillian Lieberman, MD Our Patient: MRI Sagittal and axial T2 with fat suppression sequences show a soft tissue mass surrounding the right clavicle with associated edema. There is communication of the soft tissue mass with the medullary cavity. The soft tissue mass showed enhancement with gadolinium. Jennifer Son, Year III Gillian Lieberman, MD Differential Diagnosis • Important thing