肋骨原发恶性骨肿瘤的CT诊断  

CT findings of the primary malignant tumors of the ribs

作　　者：常承[1] 彭晓新[1] 程晓光[1] 于爱红[1] 宫丽华[1] CHANG Cheng;PENG Xiao-xin;CHENG Xiao-guang;YU Ai-hong;GONG Li-hua(Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院,北京100035

出　　处：《中国临床医学影像杂志》2020年第6期441-445,共5页Journal of China Clinic Medical Imaging

基　　金：北京市卫生系统高层次卫生技术人才培养项目(编号:2009-02-03,2013-3-033)。

摘　　要：目的:分析肋骨原发恶性骨肿瘤的CT表现,探讨相关的临床影像特点。方法:回顾性分析26例肋骨原发恶性骨肿瘤病例的CT表现,总结肋骨原发恶性骨肿瘤的影像学特征。结果:软骨肉瘤14例,78.5%发生于肋骨与肋软骨交界区,表现为不规则溶骨性骨质破坏伴或不伴软组织肿块,肿块内见软骨基质钙化,多数无明显强化。浆细胞骨髓瘤4例,表现为单发或者多发溶骨性"穿凿样"或"虫蚀样"骨质破坏,其中2例可见病理性骨折。骨肉瘤3例,表现为溶骨性或混合性骨质破坏,其中1例软组织肿块内见团片状高密度瘤骨。尤文肉瘤2例,表现为不规则溶骨性骨质破坏,其中1例伴较大的软组织肿块。非霍奇金淋巴瘤、脊索瘤、纤维肉瘤各1例。结论:肋骨原发恶性骨肿瘤发病年龄及病种比较广泛,其中以软骨肉瘤最多见。部分病变都有其典型影像表现,而部分肿瘤影像学无特异性,最终诊断仍需临床、影像、病理三方面结合。Objective:To analyze the imaging appearance and to explore the diagnostic value of CT in primary malignant tumors of the ribs.Methods:Twenty-six cases with primary malignant costal tumors proved by operation and pathology were analyzed,and radiographic features were analyzed retrospectively.Results:There were 14 cases of chondrosarcoma with 78.5%arising at the costochondral junction,characterized by irregular and lytic bone destruction with cartilage matrix calcification inside.After intravenous injection,no obvious enhancement was seen.There were 4 cases of plasmacytoma,characterized by solitary or multiple,punched-out or eroded lesions.Osteosarcoma(three cases)appeared as osteolytic or mixed bone destruction,irregular calcific densities were found in one case.Ewing’s sarcoma(two cases)demonstrated as ill-defined,osteolytic lesions with a large soft tissue mass in one case.The rest were one of each of the following:non-Hodgkin’s lymphoma,chordroma,fibrosarcoma,and liposarcoma.Conclusion:The primary malignant tumors of the ribs are a complicated group and rarely encountered,some of which demonstrate the classic radiological features,but some cases with nonspecific radiological features,and the final diagnosis should consider about clinical,imaging and pathology.

关 键 词：骨肿瘤 肋骨 体层摄影术 螺旋计算机 

分 类 号：R738.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]