骶尾椎脊索瘤的CT与MRI征象分析  

CT and MRI features of sacrococcygeal chordoma

作　　者：代平 刘勇 何其舟 杨彬 

机构地区：[1]西南医科大学附属中医医院放射影像科,四川泸州646000

出　　处：《医学影像学杂志》2017年第10期1992-1995,共4页Journal of Medical Imaging

摘　　要：目的分析骶尾椎脊索瘤的CT和MRI征象,以提高诊断准确性。方法回顾性分析30例经手术病理证实的骶尾椎脊索瘤的CT和MRI表现。30例均行CT、MRI检查,其中CT增强28例,MRI增强25例。结果 30例均见骶尾椎膨胀性不规则骨质破坏,偏心性1例,中心性29例,大部分肿瘤体积较大。CT:显示钙化29例,出血4例,"反引号"征10例。增强后不均匀强化26例,较均匀强化2例。MRI:T_1WI呈低信号为主混杂信号,T_2WI呈高信号为主混杂信号,出血26例,分隔25例,假包膜18例,坏死囊变6例,"反引号"征18例,"分节现象"15例。增强后"蜂房样"强化23例。30例中,臀部肌肉受累8例,骶髂关节受累4例。结论 CT和MRI能很好显示骶尾椎脊索瘤范围、骨质破坏程度、软组织肿块及邻近组织受侵情况,其表现有一定的特征性,对提高诊断准确性具有帮助。Objective To analyze the CT and MRI features of the sacrococcygeal chordoma,so as to improve its diagnostic accuracy. Methods 30 cases of sacrococcygeal chordoma proved by pathology were examined with CT and MRI retrospectively.All of 30 cases underwent CT and MRI examinations,and 28 cases were examined by CT enhancement,25 cases by MRI enhancement. Results In 30 cases,all sacrococcygeal chordoma demonstrated expansibility and irregular bone destruction,among which eccentricity was 1 case,centrality was 29 cases,and most of the tumor presented with large size. CT demonstrated calcification in 29 cases,bleeding in 4 cases,＂anti-quote＂sign in 10 cases,uneven enhancement in 26 cases and uniform enhancement in 2 cases. On MR images,all lesions demonstrated mixed low signal intensity on T1WI and mixed high signal intensity on T2WI. The lesions presented with bleeding in 26 cases,separation in 25 cases,pseudocapsule was found in 18 cases,cystic areas in 6 cases,＂anti-quote＂sign in 18 cases,segmentation in 15 cases and ＂ honeycomb＂ reinforced in 23 cases. Hip muscle invasion in 8 cases,sacroiliac joint involvement in 4 cases. Conclusion The extension,the degree of bone destruction,the soft tissue mass and adjacent tissue involvement of the sacrococcygeal chordoma can be clearly delineated on CT and MRI. The characteristics of this disorder are very helpful to improve the diagnostic accuracy.

关 键 词：骶尾椎 脊索瘤 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] R814.42[医药卫生—临床医学]