颅骨骨肉瘤的CT、MRI影像学诊断  

Imaging Diagnosis of Skull Osteosarcoma by CT and MRI

作　　者：周茜[1] 熊佶[1] 张俊海[1] 胡星[1] 初曙光[1] 刘含秋[1] 姚振威[1] 

机构地区：[1]复旦大学附属华山医院放射科

出　　处：《中国医学计算机成像杂志》2014年第2期121-125,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨颅骨骨肉瘤的影像学表现,以期提高对本病的认识和诊断水平。方法:对经手术和病理证实的7例颅骨骨肉瘤进行回顾性分析。3例行CT检查,5例行MRI检查。结果:7例均为普通型骨肉瘤;CT上表现为软组织肿块伴骨质破坏,其内可见肿瘤骨,受累颅骨均有骨膜成骨后的明显骨质破坏;MRI信号不均匀,增强后显著不均匀强化,瘤骨在T1WI还是T2WI均表现为低或等信号,轻度强化或无强化;MRI能更清楚显示肿瘤与邻近组织结构间的关系,并判断肿瘤的范围。结论:颅骨骨肉瘤较为罕见,影像学上极易误诊,CT上肿瘤骨及其破坏的表现与MRI表现相结合,对该疾病的诊断有重要意义。Purpose： To analyze the imaging features of skull osteosarcoma, in order to improve the understanding and diagnosis of this disease. Methods： A retrospective review was performed on 7 cases of skull osteosarcoma confirmed by surgery and pathology. Three cases underwent routine CT scans and 5 cases underwent enhanced MRI examinations. Results： Seven cases were all conventional osteosarcomas in histological diagnosis. On CT scans, they all presented as soft-tissue masses with bone destruction and tumor bone formation; the involved skull appeared with obvious bone destruction after periosteal osteogenesis. On MRI scans, masses were shown with mixed intensity signals and significantly heterogeneous enhancement, while tumor bone was hypo-intensity or iso-intensity on both T1WI and T2WI. MRI could display the relationship between tumor and adjacent tissues more clearly, thus it was helpful to detect the range of tumor. Conclusion： Skull osteosarcoma is a rare tumor that can be easily misdiagnosed. Combining the manifestations of tumor bone and bone destruction on CT scan with MRI manifestations is important to make the correct diagnosis.

关 键 词：颅骨 骨肉瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R730.44[医药卫生—临床医学] R445.2