长骨溶骨型骨巨细胞瘤与溶骨型骨肉瘤的X线鉴别诊断  

Radiological Differentiation of Osteolytic Type Giant Cell Tumors from Osteolytic Osteosarcoma of Long Tubular Bones

作　　者：惠志强[1] 姚安晋 孙满祥 

机构地区：[1]西安市第一医院放射科,710002 [2]西安市影像诊断中心 [3]富平县人民医院

出　　处：《现代医用影像学》1999年第3期112-114,共3页Modern Medical Imageology

摘　　要：目的：探讨长骨溶骨型骨巨细胞瘤及溶骨型骨肉瘤的X线特征。材料与方法：比较分析经手术及病理证实的22例长骨溶骨型骨巨细胞瘤与30例长骨溶骨型骨肉瘤的X线征像。结果：长骨溶骨型骨巨细胞瘤均有不同程度的骨端松质骨破坏，破坏形态均趋于类球状，10例侵及关节面，局限性骨膜反应4例；长骨溶骨型骨肉瘤26例为干骺端松质骨破坏，4例为骨端松质骨破坏，破坏形态呈不规则片状，3例侵及关节面，30例皆有程度不一的骨膜反应，其中出现Codman’s三角者16例。结论：长骨溶骨型骨巨细胞瘤的X线特征为骨端松质骨类球状破坏；溶骨型骨肉瘤的X线特征为干骺端松质骨不规则片状破坏，伴有程度不一的骨膜反应。Purpose: Discussed the radiological characteristics of osteolytic type of giant cell tumor and osteotytic osteosarcoma in long tubular bones. Materials and Methods: The radiological signs of 22 cases of osteoytic type of giant cell tumor and 30 cases of osteoytic osteosarcoma in long tubular bones comfirmed by operation and pathology were comparatively analysed. Results: The radiological findings of 22 cases of osteolytic type of giant cell tumor showed different degree of destruction in the bone end, and the shape of distruction of bone were tend to spleroid. Articular surface were destroyed in 10 cases, Localized periosteal reaction were appeared in 4 cases; 26 cases of osteolytic osteosarcoma showed destruction of the spongiosa of metaphysis, and the shape of distruction appeared irregular pieces,Articular surface were destroyed in 4 cases. Different degree of periosteal reaction were appeared in 30 cases, among them the Codman's triangle appeared in 16 cases. Conclusion: The radiological characteristics of osteolytic type giant cell tumor of long tubular bone showed osteolytic type destruction of spongiosa of bone end. The osteolytic osteosarcoma showed infiltration destruction of the spongiosa of metaphysis, the shape of destruction appeared irregular pieces, and the different degree of periosteal reaction were appeared in all of the cases.

关 键 词：骨巨细胞瘤 骨肉瘤 X线 鉴别诊断 

分 类 号：R738.104[医药卫生—肿瘤] R730.44[医药卫生—临床医学]