髂骨和耻坐骨尤文氏肉瘤的影像学诊断及鉴别诊断  

The imaging diagnosis and differential diagnosis of Ewing’s sarcoma in ilium,pubis,and ischium

作　　者：赵向乾[1] 任静[1] 许霖[1] 任宁娟 杜希娜 宦怡[1] 

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032

出　　处：《实用放射学杂志》2015年第1期121-123,127,共4页Journal of Practical Radiology

摘　　要：目的：探讨髂骨和耻坐骨尤文氏肉瘤的影像学表现及鉴别诊断,以提高本病的术前诊断率。方法回顾性分析本院经手术后病理证实的15例髂骨和耻坐骨尤文氏肉瘤的影像学表现。所有病例均行 X 线平片检查,12例行 CT 检查,11例行 MRI 检查。结果15例中髂骨尤文氏肉瘤8例,耻坐骨尤文氏肉瘤7例。X 线平片呈单纯溶骨性骨质破坏12例,混合型骨质破坏3例,病灶周围见软组织包块15例；CT 扫描见病灶边缘膨胀、内部溶骨性骨质破坏7例,骨质破坏周围见不规则瘤骨或骨硬化5例,病灶周围见不规则骨膜反应6例。病灶周围软组织包块环绕12例；MRI 扫描病灶呈长 T1长 T2信号7例,长 T1混杂 T2信号4例,抑脂序列呈不均匀高信号5例,11例均见骨质破坏及软组织包块。结论髂骨和耻坐骨尤文氏肉瘤较少见,具有一定的影像特点, X 线平片结合 CT 扫描可以提高术前诊断准确率,MRI 检查有助于手术范围确定和治疗。Objective To investigate the imaging findings of Ewing’s sarcoma in ilium,pubis,and ischium,and to improve the diagnostic veracity.Methods The imaging manifestations of 1 5 patients with pathologically proved Ewing’s sarcoma in ilium,pubis or ischium were retrospectively analyzed.All the 1 5 patients were underwent X-ray examination.Among them,12 cases performed CT examination and 1 1 cases performed MRI examination.Results In all the 1 5 Ewing’s sarcoma patients,8 lesions located at the iliac.7 lesions located at the pubic and ischial.12 cases showed simple osteolytic bone destruction on X-ray images,3 cases showed mixed bone destruction.All the 1 5 cases showed soft-tissue mass around the lesion.On CT images,7 cases showed swelling in the periphery of the lesion areas and internal osteolytic bone destruction,5 cases showed irregular oateomas,hyperosteogeny or osteo-sclerosis surrounding bone destruction areas,6 cases showed irregular periosteal reactionsurrounding the lesion areas,12 cases showed soft-tissue mass surrounding the lesion areas.On MRI,7 cases showed long T1 and long T2 signal,4 caese showd T1 low and T2 heterogeneous high signal,5 cases showed high signal in the fat suppression sequences.All the 1 1 cases who underwent MRI examination showed bone destruction and soft tissue mass on MRI.Conclusion Although rare,Ewing’s sarcomas of the ilium,pu-bis,and ischium have some certain image features.X-ray,CT and MRI examinations play an important role in the diagnosis and dif-ferent diagnosis of these conditions.

关 键 词：髂骨 耻坐骨 尤文氏肉瘤 计算机体层成像 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]