骨肉瘤亚型的影像征象分析（附7例报告）  

Imaging Diagnosis of Subtypes of Osteosarcoma ：A Report of 7 Cases

作　　者：李立[1] 郭茂凤[1] 郭亮[1] 

机构地区：[1]苏州大学附属第一医院放射科,江苏苏州215006

出　　处：《实用放射学杂志》2009年第2期220-223,共4页Journal of Practical Radiology

摘　　要：目的分析骨肉瘤亚型的临床及影像学特征,以加深对骨肉瘤亚型的认识。方法回顾性分析7例经临床及病理证实的骨肉瘤亚型病例并结合文献深入分析其影像表现。结果本组7例病例中2例为毛细血管扩张型,分别位于股骨下段和股骨头,表现为明显膨胀性、溶骨性骨质破坏,软组织肿块明显。3例骨皮质旁型均发生于股骨,2例股骨上段,1例股骨下段,表现为高密度致密性骨块,突起的骨块与骨皮质之间见有透亮线,影像表现比较有特征性。1例小细胞型,位于股骨下段干骺端,表现为不规则的溶骨性骨质破坏,病灶密度不均,可见明显的成骨,软组织肿块明显。1例骨膜型,位于胫骨上段干骺端,表现为骨表面的软组织肿块,其内可见丛毛样钙化,与其下的骨皮质垂直并呈放射状排列。结论骨肉瘤亚型较多而复杂,部分亚型影像特征明显,部分影像诊断困难,需结合临床及病理。Abstract：Objective To research the imageological features of subtypes of osteosarcoma,and to improve the knowledge of these tumors. Methods Imaging findings of osteosarcomas in 7 cases proved clinically and pathologically were retrospectively analyzed with review of literature. Results 2 telangiectatic osteosarcomas localized in the lower end of femora and the upper end of femora respectively, the findings of imaging were expensive and dissolved osseous destruction with soft tissue mass. 3 parosteal osteosarcomas localized in femora （2 cases localized in the upper end of femora, 1 case localized in the lower end of femoral, X--ray and CT findings appeared as an uniformly dense mass projected in soft tissue. In general there was a peculiar tendency to encircle the involved bone with thin lucent zone between the tumor and the underlying cortex, i case of small cell osteosarcoma localized in lower diaphysialepi- physial of femora, had osteoclastic bony destruction. 1 case of periosteal osteosarcoma localized in the upper diaphysialepiphysial of tibia presented as a mixed radiolucent mass in the cortical. The sunburst appearance of radiating spicules of mineralized tumor oste- old at right angles to the cortical bone was seen on CT. Conclusion Some subtypes of osteosarcoma have distinct roentgenographic features respectively, which is helpful in diagnosis. Other subtypes of osteosarcoma are difficult to diagnose, the diagnosis is necessary to combine with clinic and pathological data.

关 键 词：骨 骨肉瘤 亚型 X线摄影 体层摄影术 X线计算机 

分 类 号：R738.1[医药卫生—肿瘤] R814.41[医药卫生—临床医学]