螺旋CT评价原发性颌骨骨肉瘤的价值  

Value of spiral CT in the evaluation of primary osteosarcoma of the jaws

作　　者：刘轶芳 袁瑛[1] 王晶波 朱凌[1] 陶晓峰[1] LIU Yifang;YUAN Ying;WANG Jingbo;ZHU Ling;TAO Xiaofeng(Department of Radiology,Shanghai Ninth People's Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200011,China;Community Health Service Center of Tianlin Subdistrict,Xuhui District,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第九人民医院放射科,上海200011 [2]上海市徐汇区田林街道社区卫生服务中心,上海200233

出　　处：《实用放射学杂志》2021年第3期369-372,共4页Journal of Practical Radiology

基　　金：国家自然科学基金资助项目(91859202·81771901)。

摘　　要：目的评估64排螺旋CT对原发性颌骨骨肉瘤的诊断价值。方法对60例经手术病理证实的原发性颌骨骨肉瘤的术前CT图像进行回顾性分析,分别对病灶部位、大小、形态、病灶密度、强化程度、骨皮质破坏、瘤骨、骨膜反应、软组织肿块及有无淋巴结转移进行分析。结果本组原发性颌骨骨肉瘤中,病理类型包括普通型骨肉瘤57例,小细胞型骨肉瘤2例,骨旁骨肉瘤1例。发病部位上/下颌骨(29/31)相当,病灶平均长径/平均短径为(48.41±15.02)mm/(32.95±13.80)mm,增强后病灶强化明显,平均CT值增加(47.18±19.13)HU,伴有瘤骨形成44例、骨皮质破坏52例、骨膜反应49例、周围软组织肿块53例。本组病例中淋巴结转移12例,骨肉瘤病灶的CT值低于无淋巴结转移组。结论原发性颌骨骨肉瘤主要影像学表现为骨质破坏、骨膜反应及软组织肿块,并伴有瘤骨形成的特征,螺旋CT对于原发性颌骨骨肉瘤具有良好的诊断能力。Objective To evaluate the diagnostic value of 64-slice spiral CT in primary osteosarcoma of the jaws.Methods The reoperative CT images of 60 cases of primary osteosarcoma of the jaws confirmed by surgery and pathology were analyzed retrospectively.The location,size,shape,density,enhancement,cortical destruction,neoplastic osteoid,periosteal reaction,soft tissue mass and lymph node metastasis were analyzed respectively.Results In this study,the pathological types included 57 cases of common osteosarcoma,cases of small-cell osteosarcoma and 1 case of parosteal osteosarcoma.The maxilla and mandible incidence rate was the same(29/31).The nean long diameter/mean short diameter of the lesion was(48.41±15.02)mm/(32.95±13.80)mm.In most cases,obvious enhance-nent was detected,average CT value increased by(47.18±19.13)HU.Neoplastic osteoid formation was founded in 44 cases,cortical lestruction in 52 cases,periosteal reaction in 49 cases,Peripheral soft tissue mass in 53 cases,and lymph node metastasis in 12 cases.In addition,the CT value of osteosarcoma in the cases with lymph node metastasis was lower than that in the non-metastasis group.Conclusion The major imaging findings of primary osteosarcoma of the jaws are bone destruction,periosteal reaction and soft tissue nass,accompanied by neoplastic osteoid.Spiral CT has good diagnostic ability for primary osteosarcoma of the jaws.

关 键 词：骨肉瘤 颌骨 计算机体层成像 

分 类 号：R739.91[医药卫生—肿瘤] R814.42[医药卫生—临床医学]