原发性骨外周性原始神经外胚层瘤的影像表现  

Imaging findings of primary peripheral primitive neuroectodermal tumors of bone

作　　者：夏盛伟 王旭荣 项剑瑜 Xia Shengwei;Wang Xurong;Xiang Jianyu(Department of Radiology,Wenzhou Hospital of Traditional Chinese Medicine of Zhejiang,Zhejiang Wenzhou 325000,China;Department of Radiology,Yueqing People′s Hospital of Zhejiang,Zhejiang Yueqing 325600,China;Department of Imaging,Wenzhou People′s Hospital of Zhejiang,Zhejiang Wenzhou 325000,China)

机构地区：[1]浙江省温州市中医院放射科,325000 [2]浙江省乐清市人民医院放射科,325600 [3]浙江省温州市人民医院影像科,325000

出　　处：《中国医师进修杂志》2019年第12期1121-1126,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨原发性骨外周性原始神经外胚层瘤(pPNETs)的临床和影像表现。方法回顾性分析浙江省温州市中医院、浙江省乐清市人民医院、浙江省温州市人民医院诊治的6例原发性骨pPNETs患者的临床表现和X线、CT及MRI影像学表现。结果6例中男4例,女2例,年龄2~38(18.5±12.0)岁。局部均有疼痛,其中伴肿块4例,生存(22.2±16.9)个月。髂骨2例,骶骨2例,肩胛骨1例,股骨1例。6例中行数字化X线摄影(DR)检查4例:4例骨质呈溶骨性破坏,其中伴轻度膨胀改变1例,层状骨膜反应和放射状骨针1例,软组织肿块3例。6例中行CT检查4例:4例骨质呈溶骨性破坏伴软组织肿块,未见骨膜反应,其中骨质破坏边缘见不规则硬化1例,软组织肿块内见细点状钙化2例。6例中行MRI检查4例:病变于T1WI呈等信号3例,中等偏高信号1例;T2WI和STIR序列呈不均匀中、高信号3例,均匀高信号1例;4例均见软组织肿块和瘤周水肿。结论骨pPNETs骨质以溶骨性破坏伴软组织肿块、有或无骨膜反应和瘤内有或无钙化为特征,影像学检查有助于了解病变的范围、治疗措施的制定和治疗效果的评价。Objective To investigate the clinical and imaging features of primary peripheral primitive neuroectodermal tumors(pPNETs)of bone.Methods Clinical and X-ray,CT and MRI findings of 6 cases of primary bone pPNETs in Wenzhou Hospital of Traditional Chinese Medicine of Zhejiang,Yueqing People′s Hospital of Zhejiang,and Wenzhou People′s Hospital of Zhejiang were retrospectively analyzed.Results There were 4 males and 2 females,aged from 2 to 38 years,with an average age of(18.5±12.0)years old.Local pain was found in all cases,including 4 cases with mass,with an average survival of(22.2±16.9)months.Iliac bone tumor was found in 2 cases,sacrum in 2 cases,scapula in 1 case and femur in 1 case.Digital radiography(DR)examination was performed in 4 cases:4 cases showed osteolytic destruction,including 1 case with mild swelling changes,1 case with laminar periosteal reaction and radial bone needle,and 3 cases with soft tissue mass.CT examination was done in 4 cases,and there were 4 cases of osteolytic destruction accompanied by soft tissue mass without periosteal reaction.Among them,1 case had irregular sclerosis at the edge of bone destruction and 2 cases had fine calcification in soft tissue mass.MRI examination in 4 cases:there were 3 cases with equal signal on T1WI and 1 case with moderate to high signal on T1WI,3 cases with inhomogeneous medium and high signal on T2WI and STIR,and 1 case with homogeneous high signal on T1WI,and 4 cases with soft tissue masses and peritumoral edema.Conclusions Bone pPNETs is characterized by osteolytic destruction with soft tissue masses,periosteal reaction with or without periosteal reaction,and intratumoral calcification.Imaging examination is helpful to understand the extent of lesions,formulation of therapeutic measures and evaluation of therapeutic effect.

关 键 词：骨肿瘤 外周性神经外胚瘤 影像学 

分 类 号：R73[医药卫生—肿瘤]