脊柱尤文氏肉瘤CT和MRI表现  

CT and MRI Appearances of Spinal Ewing's sarcoma

作　　者：林笑丰[1] 陈玥瑶[1] 袁小平[1] 杜开利[2] 谢榜昆[1] 

机构地区：[1]中山大学孙逸仙纪念医院放射科,广东广州510120 [2]中山大学孙逸仙纪念医院骨科,广东广州510120

出　　处：《岭南现代临床外科》2010年第1期57-60,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨脊柱尤文氏肉瘤(Ewing's Sarcoma,ES)的CT和MRI表现。方法回顾性分析经病理证实的7例脊柱ES的影像学资料。结果病变累及颈椎、胸椎各3例、腰椎1例。CT检查:2例椎体和/或附件溶骨性骨质破坏,3例椎管内外软组织肿块。MRI检查:7例均表现椎管内外肿物,瘤体T1WI表现为等、低或稍高信号,6例T2WI表现为不均匀高信号,增强后不均匀强化;1例T2WI上为均匀稍高信号,增强后均匀强化。免疫组织化学:肿瘤均表达CD99阳性。结论青少年患者进行性发展的椎管内外软组织肿块伴脊柱溶骨性骨质破坏,提示脊柱ES可能。脊柱ES需结合病理学及免疫组化确诊。CT、MRI综合使用为脊柱ES诊断、治疗、疗效评价及预后提供帮助。Objective This study was to analyze the imaging features of Spinal Ewing＇s sarcoma（ES）.Methods：CT,MRI,and pathologic reports of 7 ES patients were reviewed.Results Vertebral column distribution was 3 cervical,3 thoracic,1 lumbar.Among three cases scanned by CT,osteolytic bone destruction of vertebral body and /or posterior elements in 2 cases and paraspinal and intraspinal soft tissue mass in 3 cases were observed.All lesions located at the paraspinal and intraspinal tissue on MRI images.T1-weighted image showed low,equal or slightly high signal in 7cases.T2-weighted image showed uneven high signal and contrast image showed heterogeneous enhancement in 6 cases.Only one case had slightly high signal on T2-weighted image and homogeneous enhancement on contrast image.According to Immunohistochemical results,CD99 in all cases were positive.Conclusions Spinal ES should be considered in adolescent patients with aggressive osteolytic bone destruction of vertebrae and paraspinal and intraspinal soft tissue mass.The final diagnosis of spinal ES depends on the pathologic and immunohistochemical determinations.CT and MRI should be accurately and synthetically used on spinal ES,which can give more information to diagnosis,treatments,evaluating curative effects and prognosis.

关 键 词：脊柱 肉瘤 Ewing 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]