脊柱软骨源性肿瘤的影像分析及鉴别  

Imaging Analysis and Differential Diagnosis of Cartilage-Derived Tumor in Spine

作　　者：张立华[1] 袁慧书[1] ZHANG Lihua;YUAN Huishu(Department of Radiology,Peking University Third Hospital,Beijing 100191,P.R.China)

机构地区：[1]北京大学第三医院放射科,100191

出　　处：《临床放射学杂志》2020年第7期1379-1383,共5页Journal of Clinical Radiology

摘　　要：目的探讨脊柱软骨源性肿瘤的CT和MRI影像表现,分析不同类型软骨源性肿瘤的特点,以提高对软骨源性肿瘤术前准确诊断率。方法对46例临床病理证实发生于脊柱的软骨来源肿瘤的影像表现进行回顾,分析不同类型软骨源性肿瘤的骨破坏部位、类型、生长方式、MRI信号和增强特点。结果脊柱软骨来源的肿瘤共46例,其中软骨肉瘤36例(78.3%),骨软骨瘤7例(15.2%),软骨母细胞瘤3例(6.5%);男26例,女20例,平均年龄(38.6±14.3)岁;颈椎、胸椎、颈胸椎、腰椎及骶椎分别为21例(45.7%)、14例(30.4%)、2例(4.3%)、6例(13.0%)和3例(6.5%);病变位于椎体、附件及椎体附件均累及者分别为7例(15.2%)、16例(34.8%)和21例(45.7%),2例软骨肉瘤位于椎管内;软骨肉瘤、骨软骨瘤和软骨母细胞瘤合并骨破坏者占57%;合并钙化者占61%;累及相邻脊柱者占43%;外生性生长者占50%,伴椎旁软组织肿块形成者占76%。结论脊柱软骨源性肿瘤好发于颈胸椎,以软骨肉瘤最常见,以外生性生长为主、钙化比较常见;是否合并骨破坏与肿瘤部位及具体类型有关。软组织肿块对肿瘤的良恶性有鉴别意义。Objective To investigate the CT and MRI imaging manifestations of cartilage-derived tumors of the spine,and analyze the characteristics of different types of cartilage-derived tumors,so as to improve the accurate diagnosis rate of cartilage-derived tumors before operation.Methods The imaging manifestations of 46 cases of cartilage-derived tumors confirmed by clinicopathology in the spine were reviewed,and the bone destruction sites,types,growth patterns,MRI signals and enhancement characteristics of different types of cartilage-derived tumors were analyzed.Results There were 46 cases of spinal cartilage-derived tumors,including 36 cases of chondrosarcoma,7 cases of osteochondroma,3 cases of chondroblastoma,accounting for 78%,15%and 7%respectively;26 males and 20 females,with an average Age(38.6±14.3)years.The cervical,thoracic,cervical-thoracic,lumbar and sacral spine regions were involved in 21 cases,14 cases,2 cases,6 cases and 3 cases,accounting for 46%,30%,4%,80%,7%and 3%cases,respectively.The lesions located in the vertebral body,appendages and appendages of the vertebral body were seen in 7 cases(15%),16 cases(35%)and 21 cases(46%)respectively.2 cases of chondrosarcoma were located in the spinal canal.Chondrosarcoma,osteochondroma,and chondroblastoma were associated with bone destruction which accounted for 57%;lesions associated with calcification accounted for 61%;lesions with adjacent spine involvement accounted for 43%.Exogenous growth accounted for 50%,association with paravertebral soft tissue mass accounted for 76%of the cases.Conclusion Cartilage-derived tumors of the spine tend to occur in the cervical and thoracic spine.Chondrosarcoma is the most common,presenting predominantly with exogenous growth and calcification.Presence of associated bone destruction is related to the location and the specific type of the tumor.Soft tissue masses are of significance in differentiating benign and malignant tumors.

关 键 词：骨软骨瘤 软骨母细胞瘤 软骨肉瘤 脊柱 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤]