颅面骨骨肉瘤的CT和MRI诊断及鉴别  

Diagnosis and Differential Diagnosis of Craniofacial Osteosarcoma by CT and MRI

作　　者：邓磊[1] 邹玉坚[1] 曾雪伟[2] 秦耿耿[3] DENG Lei;ZOU Yu-jian;ZENG Xue-Wei;QIN Geng-geng(Department of Radiology, Dongguan People’s Hospital;Department of Radiology, Foshan Hospital of Traditional Chinese Medicine;Department of Radiology, Nanfang Hospital, Southern Medical University)

机构地区：[1]东莞市人民医院放射科 [2]佛山市中医院放射科 [3]南方医科大学南方医院放射科

出　　处：《中国医学计算机成像杂志》2019年第1期53-57,共5页Chinese Computed Medical Imaging

基　　金：广东省医学科学技术研究基金青年项目;项目编号:A2017496;广东科技计划项目;项目编号:2016ZC0058~~

摘　　要：目的:探讨颅面骨骨肉瘤的CT和MRI征象。方法:收集2005年8月到2017年11月15例经手术病理证实的颅面骨骨肉瘤的术前CT(14/15)、MRI(6/15)资料,男女比3:2,平均年龄42.8岁。原发性骨肉瘤8例,继发性骨肉瘤7例。对病灶部位、边界、内部成分、瘤骨、周围软组织分别进行分析。结果:病灶位于上颌骨6例,下颌骨4例,鞍区2例,颞颌关节1例,同时累及颧骨及上颌骨、下颌骨1例,同时累及蝶骨和鞍区1例。CT图像显示所有病灶均有不同程度骨质破坏,骨皮质部分或全部突破,有瘤骨形成者7例,其中5例为团块状瘤骨。MRI平扫信号多样,强化均匀或不均。结论:颅面骨骨肉瘤均出现不同程度骨破坏,伴瘤骨的概率较高,且常继发于放疗后和长期的骨化性纤维瘤,CT+MRI可较好地鉴别骨肉瘤和多种良恶性骨病变。Purpose: To investigate the CT and MRI findings of craniofacial osteosarcoma. Methods: Preoperative CT(14/15) and MRI(6/15) data of 15 cases of craniofacial osteosarcoma confirmed by surgical pathology results were collected from August 2005 to November 2017. There were 9 men and 6 women. Their mean age was 42.8 years old.There were 8 cases of primary osteosarcoma and 7 cases of secondary osteosarcoma. The location, boundary, internal composition, tumor bone and surrounding soft tissue of the lesions were analyzed respectively. Results: The location of the lesion was maxillary bone in 6 cases, mandible in 4 cases, sella region in 2 cases, temporomandibular joint in1 case,zygomatic bone and maxilla and mandible in 1 case, sphenoid bone and sella region in 1 case. CT images showed that all lesions were with different grades of bone destruction, partial or total breakthrough of the bone cortex;7 cases with tumor bone formation, 5 of which were with tuberous tumor bone. The MRI signal intensity of the lesions were varied and uniform or uneven. Conclusions: There is different degree bone destruction in craniofacial osteosarcoma. Tumor bone is more often seen secondary to radiotherapy and long-term ossifying fibroma. Osteosarcoma and a variety of benign and malignant bone lesions can be well identified by CT and MRI.

关 键 词：颅面骨 骨肉瘤 CT MRI 

分 类 号：R445.2[医药卫生—影像医学与核医学] R445.3[医药卫生—诊断学]