胸骨肿瘤的CT诊断  

Diagnosis of Sternal Tumor with MSCT

作　　者：陈韵彬[1] 卢涛[1] 蔡林峰[1] 

机构地区：[1]福建医科大学教学医院,福建省肿瘤医院放射科,福州350014

出　　处：《放射学实践》2005年第6期511-513,共3页Radiologic Practice

摘　　要：目的:提高胸骨肿瘤的CT鉴别诊断能力。方法:回顾性分析40例经病理证实的胸骨肿瘤患者的CT资料。结果:胸骨肿瘤具有膨胀性生长的倾向;良、恶性膨胀性破坏的区别在于前者有硬化边,后者边缘模糊、血供丰富、生长迅速。瘤软骨、骨样物质、骨质穿凿样破坏分别是软骨类肿瘤、骨肉瘤、多发性骨髓瘤的重要诊断依据。粒细胞肉瘤胸骨浸润CT不具有诊断意义的特征,若无白血病的临床背景,与淋巴瘤、肉芽肿等病变鉴别有困难。骨髓造血源性肿瘤相对好发于胸骨。乳癌胸骨转移骨质破坏以成骨为主伴溶骨,其它转移癌以溶骨为主。发现孤立膨胀性侵袭性胸骨破坏时,应常规检查肾脏、甲状腺、肝脏等部位。结论:MSCT是胸骨肿瘤的首选影像技术能提供胸骨病灶的微细改变,准确显示肿瘤的形态、体积及浸润范围,判断肿瘤的性质。Objective:To improve ability of CT for differential diagnosis of sternal tumors.Methods:The CT results from 40 patients with sternal tumors were retrospectively analyzed.Results:Sternal tumors had expansive developing tendency;the benign expansive destruction had the characteristics of sclerotic margin and the malignant expansive destruction had the characteristics of indistinct margin,abundant blood supply,and rapid growth.The CT results strongly suggested an underlying cartilaginous neoplasm owing to the appearance of typical mineralized cartilage matrix,osteosarcoma owing to the appearance of osteoid substance,multiple myeloma owing to the appearance of typical osteolytic change.It was difficult to distinguish granulocytic sarcoma from lymphoma and granuloma by the CT characters of sternal infiltration,if there was no clinical manifestation of leukemia.The sternum was a relative predilection site for hematopoietic malignant skeletal destruction.The metastasis of tumor showed osteolytic lesion on CT while the sternal metastasis of breast cancer showed a predominantly osteoblastic lesion,accompanied with lytic pattern.When appearance of solitary aggressive expansive sternal change was shown,thyroid gland,kidney and liver should be examined routinely.Conclusion:MSCT could detect subtle change of sternum tumors by accurately providing the tumor shape,volume and the extent and it could be used to differentiate the benign tumor and the malignant disease.It was the best imaging technique for the diagnosis of sternal tumor.

关 键 词：胸骨 肿瘤 诊断 体层摄影术 X线计算机 

分 类 号：R738.1[医药卫生—肿瘤]