恶性骨肿瘤周围骨髓水肿的MRI征象分析  

MR imaging of edema accompanying malignent bone tumors

作　　者：曲宁[1,2] 于台飞[3] 徐琦 陈海松[1] QU Ning;YU Taifei;XU Qi;CHEN Haisong(Department of Radiology,The Affilited Hospital of Qingdao University,Qingdao 266003,P.R.China;Department of Radiology,Qingdao Hospital of Traditional Chinese Medicine(Qingdao Hiser hospital),Qingdao 266033,P.R.China;Department of Medical Imaging Radiology,Shandong Provicial Hospital Affilited to Shandong First Medical University,Jinan 250021,P.R.China)

机构地区：[1]青岛大学附属医院放射科,山东青岛266003 [2]山东省青岛市中医医院(青岛市海慈医院)放射科,山东青岛266033 [3]山东第一医科大学附属省立医院医学影像科,山东济南250021

出　　处：《医学影像学杂志》2021年第9期1575-1578,共4页Journal of Medical Imaging

基　　金：国家自然科学基金项目(编号:81571673);青岛大学附属医院“临床医学+X”科研项目(编号:QDFY+X2021016)。

摘　　要：目的探讨恶性骨肿瘤周围骨髓水肿在MRI中的显示率及表现特征。方法回顾性分析经手术病理证实的恶性骨肿瘤218例,在脂肪预饱和T 2WI脂肪抑制序列或STIR脂肪抑制序列中观察瘤周骨髓水肿情况。瘤周骨髓水肿的大小被分级,Ⅰ级:骨髓水肿最长径小于肿瘤最长径;Ⅱ级:骨髓水肿最长径和肿瘤最长径相当;Ⅲ级:骨髓水肿最长径大于肿瘤最长径。运用单因素方差分析对不同恶性骨肿瘤之间骨髓水肿出现率及水肿大小进行统计学分析。结果所有恶性骨肿瘤中,瘤周骨髓水肿总体出现率为77.52%(169/218),其中骨肉瘤的骨髓水肿出现率最高,其次为软骨肉瘤和骨转移瘤,骨髓瘤的骨髓水肿出现率最低。骨肉瘤的骨髓水肿出现率与转移瘤、骨髓瘤比较均有明显统计学差异。所有恶性骨肿瘤中,Ⅰ级水肿最多,占59.63%(130/218),Ⅰ级水肿和无骨髓水肿者共占82.11%。结论骨髓水肿是恶性骨肿瘤的一种常见征象,多见于骨肉瘤、软骨肉瘤、骨转移瘤。多数恶性骨肿瘤的周围骨髓水肿范围小于肿瘤本身,这一征象对恶性骨肿瘤的诊断有提示作用。Objective To explore the incidence and significance of bone marrow edema associated with malignent bone tumors.Methods Magnetic resonance imaging(MRI)data from 218 malignent bone tumors diagnosed by pathology were retrospectively reviewed.Bone marrow edema was defined on Fat pre-saturated T 2WI inhibition sequence or STIR fat inhibition sequence in all cases.The amount of the edema was graded,gradeⅠ:the largest diameter of edema was smaller than that of the tumor;gradeⅡ:the largest diameter of edema was equivalent to that of the tumor;and gradeⅢ:the largest diameter of edema was greater than that of the tumor.The incidence rate of bone marrow edema and the size among different malignent tumors were determined using univariate analysis.Results Of all cases,there were 169 lesions with edema,the total incidence rate of edema was 77.52%(169/218).The highest incidence rate of edema was osteosarcoma,then was followed by chondrosarcoma and metastasis,myeloma was the least.There were statistically significant differences of the incidence of bone marrow edema between osteosarcoma and chondrosarcoma,osteosarcoma and myeloma.Of all cases,gradeⅠedema was the most common,accounting for 59.63%(130/218),GradeⅠand without edema accounted for 82.11%.Conclusion Bone marrow edema is a commom finding associated with malignant bone tumors,and they are frequently detected in osteosarcoma,chondrosarcoma and metastasis.Bone marrow edema surrounding the most malignent bone tumors is smaller than the lesion itself,which is suggestive of malignent bone tumors.

关 键 词：恶性骨肿瘤 骨髓水肿 磁共振成像 

分 类 号：R738.11[医药卫生—肿瘤] R445.2[医药卫生—临床医学]