原发性软骨肉瘤的影像表现和病理相关性  

Imaging of primary chondrosarcomas：radiologic-pathologic correlation

作　　者：董军强[1] 李春梅[1] 宦怡[1] 刘莹[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7期1159-1162,共4页Journal of Practical Radiology

摘　　要：目的：探讨原发性软骨肉瘤的影像表现和病理的相关性。方法回顾分析21例经病理证实的原发性软骨肉瘤的影像表现,分析与病理的相关性。结果21例软骨肉瘤的病理学分型包括普通型15例,间质型1例,黏液型2例,去分化型1例,未分型2例。普通型中6例1级和8例2级 X 线平片见溶骨性膨胀性骨质破坏伴软组织肿块11例,局部骨皮质增厚2例,明显钙化6例、隐约钙化3例。6例1级、6例2级、1例3级中 CT 见骨膜反应1例,局部骨皮质增厚2例,明显钙化7例、隐约钙化5例。CT、MRI 均见膨胀性溶骨性骨质破坏伴软组织肿块。5例1级 MR 全部病灶境界清楚,T2 WI 均呈显著混杂高信号,其内见弓环状、点状低信号分隔影。结论依据原发性软骨肉瘤的影像表现一定程度上可以推测病理学类型,在显示病理特征方面,MR 优于 CT 和 X 线平片。Objective To study imaging features of primary chondrosarcomas and the correlation with pathologic basis.Methods The imaging materials of primary chondrosarcoma in 21 cases were retrospectively analyzed and correlated with pathological results. Results In 21 cases,the pathologic classifications were as following：15 cases of conventional intramedullary,1 case mesenchymal,2 cases myxoid,1 case dedifferentiated and 2 cases with no subtypes.For 6 cases of conventional intramedullary in gradeⅠand 8 cases in gradeⅡ,bone destruction in varying degrees accompanied with soft tissue mass（n=1 1）,regional thickening cortical bone （n=2）,“ring-arc”like matrix mineralization（n=6）,amorphous （n=3）were showed on X-ray study.CT were performed,in 6 cases in gradeⅠ,6 cases in gradeⅡ and 1 case in grade Ⅲ in which there were intraosseous calcification （n=12）,regional thickening cortical bone （n=2）and periosteal new bone formation （n=1）.Lesions appeared expansive or osteolytic bone destruction accompanied with soft tissue mass on CT and MRI srudy MRI were performed in 5 cases in gradeⅠ and lesions were heterogeneous high signal intensity on T2 WI with spot like and “ring-arc”like low signal intensity.Conclusion Pathologic classifications and grading of primary chondrosarcoma may be presumed with imaging features.Pathologic characteristic manifestions on MR are superior to that on CT and X-ray.

关 键 词：软骨肉瘤 计算机体层成像 磁共振成像 病理学 

分 类 号：R738.3[医药卫生—肿瘤] R814.42[医药卫生—临床医学]