11例脊柱骨肉瘤的影像学研究  

Imaging Findings of Spinal Osteosarcomas: An Analysis of 11 Cases

作　　者：王文娜[1] 向杰[2] 曾利泉[1] 

机构地区：[1]广州军区广州总医院附属157医院放射科 [2]广州军区广州总医院附属157医院院办

出　　处：《临床放射学杂志》2014年第11期1739-1742,共4页Journal of Clinical Radiology

摘　　要：目的探讨脊柱骨肉瘤的X线、CT与MRI特征表现。方法搜集2004年5月至2013年11月由手术（n=8）或活检病理（n=3）证实的11例脊柱骨肉瘤,男6例,女5例,年龄12-49岁,中位年龄18岁。回顾分析其临床特点及X线（n=11）、CT（n=9）、MRI（n=10）征象。结果 11例中发生于颈椎1例,胸椎3例,腰椎3例,骶椎4例。X线和CT：3例表现为纯溶骨性骨质破坏,未见明确瘤骨;6例可见瘤骨,其中4例可见典型的团块状或云絮状瘤骨,2例为小斑片状和（或）条索状。MRI：T1WI上9例表现为低信号或低、等混杂信号,T2WI上9例表现为等信号或等、高混杂信号,1例伴有多发液-液平面,增强扫描大部分为明显不均匀或边缘强化。结论脊柱骨肉瘤多表现为单个椎体偏心性骨质破坏,常伴特征性瘤骨形成,无骨膜反应,但缺乏瘤骨时与其他恶性骨肿瘤难以鉴别,综合运用X线、CT及MRI能进一步提高术前诊断率。Objective To explore the X-ray,CT and MRI features of spinal osteosarcomas. Methods A total of 11 patients with surgically-proved（ n = 8） or pathologically-proved（ n = 3） spinal osteosarcoma were enrolled in this study.The patients were encountered at authors＇ hospital during the period from May 2004 to Nov. 2013. The X-ray（ n = 11）,CT（ n = 9） and MRI（ n = 10） findings and the clinical features were retrospectively analyzed. Results The lesions occurred at cervical（ n = 1）,thoracic（ n = 3）,lumbar（ n = 4） and sacral（ n = 4） vertebrae. X-ray and CT findings included pure osteolytic bone destruction with no obvious tumor bone（ n = 3）,tumor bone formation（ n = 6） presenting as typical lump or cloudy bone-density shadow（ 4 /6）,and small patch and / or cord-like shadows（ n = 2）. On MRI T1 WI,low-signal or low- and iso-mixed signal was demonstrated in 9 cases,while on T2 WI iso-signal or iso- and hyper-signal was seen in9 cases. In one case multiple fluid-fluid levels were observed. On contrast-enhanced scanning most lesions showed obvious inhomogeneous enhancement or marginal enhancement. Conclusion Usually,spinal osteosarcomas are characterized by eccentric bone destruction of single vertebra associated with typical tumor bone formation without periosteal reaction. The differentiation from other malignant bone tumors will be difficult when the tumor bone is lack. Combination use of X-ray,CT and MRI can further improve its preoperative diagnosis accuracy.

关 键 词：脊柱 骨肉瘤 CT MRI 

分 类 号：R738.1[医药卫生—肿瘤]