长骨内生软骨瘤与低级别软骨肉瘤的MRI鉴别诊断  

The use of MRI to distinguish enchondroma from low-grade chondrosarcoma of long bone

作　　者：王春桃[1] Wang Chuntao(Department of Radiology,Jiaozuo NO.2 People Hospital,Jiaozuo 454100,China)

机构地区：[1]焦作市第二人民医院放射科,河南焦作454100

出　　处：《河南医学研究》2018年第21期3867-3870,共4页Henan Medical Research

摘　　要：目的探讨长骨内生软骨瘤与低级别软骨肉瘤的MRI鉴别诊断。方法回顾性分析焦作市第二人民医院2014年7月至2017年7月经手术病理确诊的18例长骨内生软骨瘤及14例长骨低级别软骨肉瘤患者的临床及影像资料。所有患者术前均接受MRI平扫检查,记录并比较其影像学征象,包括肿瘤位置(股骨、肱骨、胫骨等;干骺端、骨干;偏心、中心型)、大小、边界、形态、信号强度,骨质改变(骨质膨胀、中断破坏、骨膜反应),邻近髓腔内及周围软组织信号改变,有无软组织肿块。结果内生软骨瘤与低级别软骨肉瘤最常见发病部位均为股骨干骺端,呈偏心型生长,差异无统计学意义(P> 0. 05)。内生软骨瘤长径为1. 4～4. 7 cm,中位长径为3. 7 cm,软骨肉瘤长径为4. 7～8. 5 cm,中位长径为5. 8 cm,低级别软骨肉瘤长径较内生软骨瘤大,差异有统计学意义(P <0. 05)。内生软骨瘤和低级别软骨肉瘤MRI检查T1、T2信号强度相比,差异有统计学意义(均P <0. 05)。内生软骨瘤病变边界清晰,低级别软骨肉瘤大部分边界不清;内生软骨瘤病变形态为类圆形较多,低级别软骨肉瘤为分叶状;低级别软骨肉瘤存在骨质破坏、骨膜反应、邻近髓腔信号改变、软组织肿块、邻近软组织异常信号等,内生软骨瘤不存在,以上各项影像学征象或表现相比,差异有统计学意义(均P <0. 05)。结论通过MRI影像对长骨内生软骨瘤与低级别软骨肉瘤进行鉴别时,骨皮质破坏、骨膜反应、软组织肿块、邻近髓腔及软组织异常信号提示为低级别软骨肉瘤。Objective To investigate the differential diagnosis of long bone enchondroma and low-grade chondrosarcoma by MRI.Methods The clinical and imaging data of 18 cases of long bone endogenous chondroma and 14 cases of low-grade chondrosarcoma of long bones confirmed by operation and pathology from July of 2014 to July of 2017 in Jiaozuo NO.2 People Hospital were retrospectively analyzed.All patients underwent MRI plain scan before operation,and their imaging features were analyzed and recorded,including tumor location(femur,humerus,tibia,metaphyseal,diaphyseal,eccentric or central),size,boundary,morphology,changes in the quality(bone expansion,disruption,periosteal reaction),adjacent intramedullary and surrounding soft tissue signal changes,with or without soft tissue mass.Results The most common sites of endogenous chondroma and low-grade chondrosarcoma were femoral metaphysis,which showed eccentric growth,and the difference was not statistically significant(P>0.05).he endogenous chondroma has a long diameter of 1.4-4.7 cm and a median long diameter of 3.7 cm.The long diameter of chondrosarcoma is 4.7-8.5 cm,and the median long diameter is 5.8 cm.The long-term diameter of low-grade chondrosarcoma was larger than that of endogenous chondroma,and the difference was statistically significant(P<0.05).The T 1 and T 2 signal intensity of endogenous chondroma and low-grade chondrosarcoma were statistically significant(P<0.05).The boundary of endogenous chondroma is clear,and most of the low-grade chondrosarcoma is unclear.Endogenous chondroma lesions are more rounded,and low-grade chondrosarcoma is lobulated.Low-grade chondrosarcoma has bone destruction,periosteal reaction,adjacent medullary cavity signal changes,soft tissue mass,adjacent soft tissue abnormal signals,etc.Endogenous chondromas do not exist.There were significant differences in the above imaging findings or performance between the two groups(all P<0.05).Conclusion When MRI is used to identify endogenous endochondroma and low-grade chondrosarcoma,cortical bone

关 键 词：骨肉瘤 软骨瘤 核磁共振成像 鉴别诊断 

分 类 号：R445[医药卫生—影像医学与核医学]