颅底软骨肉瘤的影像表现及病理对照研究  

Imaging features and pathological analysis of chondrosarcoma in the skull base

作　　者：李众[1] 纪玉强[1] 漆婉玲 李健[1] 陈立婷[1] LI Zhong;JI Yuqiang;QI Wanling;LI Jian;CHEN Liting(Department of Radiology, the First Affiliated Hospital of Nanchang University, Nanchang 330006,Chin)

机构地区：[1]南昌大学第一附属医院放射科,江西南昌330006

出　　处：《实用放射学杂志》2018年第7期1010-1013,共4页Journal of Practical Radiology

摘　　要：目的 探讨颅底软骨肉瘤的CT及MRI的影像特征。方法 回顾性分析由病理证实的15例颅底软骨肉瘤患者的临床及影像资料，并与其病理结果对照。结果 本组15例中，有9例高分化软骨肉瘤，6例间叶性软骨肉瘤（1例骨外间叶性软骨肉瘤）。15例均行CT平扫，密度不均匀，11例见钙化，其中9例表现为多发颗粒状，1例为絮状，1例为微小钙化,病灶均表现为膨胀性或侵蚀性骨质破坏；4例行CT增强扫描，3例呈絮状中度强化，1例呈均匀明显强化。15例均行MRI平扫及增强扫描，平扫均呈等、稍长T1，等、稍长T2信号；增强扫描13例呈不均匀明显强化，可见分隔及周边强化，2例呈明显均匀强化。结论 CT平扫肿块内钙化及MRI增强扫描“花环状”强化具有一定特征性，有助于提高颅底软骨肉瘤的术前诊断率。Objective To investigate the CT and MRI features of chondrosarcorna in the skull base.Methods Fifteen patients with pathologically proven chondrosarcoma were reviewed retrospectively. The imaging findings, clinical data and pathological findings were analyzed.Results In 15 cases of skull base chondrosarcoma, there were high differentiated chondrosarcoma （n=9）, mesenchymal chondrosarcoma （n=6） including one case of bone matrix mesenchymal chondrosarcoma.The CT scan was performed in 15 cases and the density was heterogeneous. Calcification was seen in 11 cases, including multiple granules （n=9） , flocculen calcification （n=1） and microcalcification （n=1 ）. All of the cases showed expansive or aggressive hone destruction. Four cases underwent enhanced CT scanning, there were flocculent moderate enhancement （n=3）, homogeneous obvious enhancement（n=1 ）.15 cases underwent MRI scan and enhanced scan.All showed slightly or low signal on T1 WI and slightly or high signal on T2 WI. On enhanced scan, 13 cases showed obvious heterogeneous accompanied with septa and peripheral enhancement, and 2 cases showed homogeneous enhancement. Conclusion The characteristic findings of skull base chondrosarcoma is calcification on CT scan and enhancement like flower ring on MRI, which can be helpful to improve the preoperative diagnostic rate.

关 键 词：颅底肿瘤 软骨肉瘤 计算机体层成像 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R738.3[医药卫生—临床医学]