| 少见型软骨肉瘤的CT和MRI表现 |
| |
| 引用本文： | 赵育英,毛新峰,李雄峰.少见型软骨肉瘤的CT和MRI表现[J].中华全科医学,2018,16(4):611. |
| |
| 作者姓名： | 赵育英 毛新峰 李雄峰 |
| |
| 作者单位： | 1. 湖州市中心医院放射科, 浙江 湖州 313000; |
| |
| 基金项目： | 2014浙江省卫生厅医药卫生平台计划(2014RCA-028) |
| |
| 摘 要： | 目的 探讨少见型软骨肉瘤(uncommon chondrosarcoma,uCHS)的CT及MR表现,以提高对该病的认识。 方法 回顾性分析湖州市中心医院2004年6月-2016年1月14例经手术或穿刺活检病理证实的少见型软骨肉瘤的CT及MR表现,其中6例行CT平扫、4例行CT平扫及增强检查,9例行MR平扫及增强检查。 结果 14例分别位于后腹膜、后纵隔、前纵隔、左侧大腿、寰椎、右侧坐骨、左侧耻骨、右侧鞍旁、右侧岩骨、右侧髋臼、胸椎、左侧顶骨、左侧肋骨、左侧肩胛骨。①黏液型5例,CT表现为膨胀性、溶骨性骨质破坏,周围见软组织影,呈分叶状或不规则形,钙化少或无。MRI以明显长T1长T2为主的混杂信号影,增强后病灶呈不均匀强化,1例病灶内见片状出血灶。②间叶型4例,位于骨外,表现为软组织团块内均匀散在点状钙化影,2例呈"满天星"样改变。③透明细胞型3例,CT表现为溶骨性骨质破坏,肿瘤组织内钙化或骨化较少见;2例T2WI内见低信号分隔,增强后边缘及分隔呈"花环状""扇贝样"强化。2例病灶内出血,并见"液-液"平面。④去分化型2例,表现为具有2种形态组织特点的"双相征"。即肿瘤由低级别软骨肉瘤和高级别梭形细胞肿瘤组成,主要表现为溶骨性骨质破坏伴周围无钙化软组织影。 结论 uCHS的临床及影像学表现缺乏特异性,CT、MRI检查能清楚显示肿瘤部位、内部结构及相邻组织关系,有助于术前手术方案的确定和术后疗效的评价,确诊仍有赖于组织病理学和免疫组化检查。
|
| 关 键 词： | 软骨肉瘤 体层摄影术，X线计算机成像 磁共振成像 |
| 收稿时间： | 2017-06-11 |
CT and MRI imaging manifestations of uncommon type of chondrosarcoma |
| |
| Affiliation: | Department of Radiology, Huzhou Central Hospital, Huzhou, Zhejiang 313000, China |
| |
| Abstract: | Objective To explore the CT and MRI findings of uncommon type of chondrosarcoma (uCHS), and improve the diagnosis and treatment of uncommon type of chondrosarcoma. Methods CT and MRI imaging features of 14 cases of uCHS confirmed by surgery or needle biopsy and pathological examination were retrospectively analyzed. The imaging data included plain CT (n=6) and contrast enhanced CT (n=4), as well as plain and contrast enhanced MRI (n=9). Results Total 14 lesions were respectively located in posterior peritoneum, anterior mediastinum, posterior mediastinum, left thigh, atlas, left ischium, left pubis, right parasellar region, right petrosum, right cotyle, thoracic vertebras, left parietal bone, left rib, left scapula respectively. ①Myxoid chondrosarcoma in 5 cases:Mild expansive or osteolytic bone destruction accompanies extraosseous lobulated or irregular soft tissue masses with few calcifications were showed on CT imaging. MRI scanning showed obviously heterogeneous long T1 long T2 signal and heterogeneous enhancement after contrast administration. One case associated hemorrhage. ②Mesenchymal chondrosarcoma in 4 cases:All of the lesions were located outside bones accompany soft tissue masses with scattered grit calcification. Two cases exhibited open-herding appearance. ③Clear cell chondrosarcoma in 3 cases:The lesions showed osteolytic bone destruction combined with extraosseous tissue masses included rarely calcification on CT imaging. The hypo-intense septa were seen on T2WI and the peripheral and septal enhancement with wreath- or shell-like appearance was showed on post-contrasted MRI. Two cases demonstrated fluid-fluid level because of hemorrhage. ④Dedifferentiated chondrosarcoma in 2 cases:Two lesions showed "bimorphic features" with different tumors features mixed within the lesion. The tumors constituted by low-grade chondrosarcoma and high-level sarcomas variability, demonstrated osteolytic destruction with unmineralized soft-tissue mass. Conclusion CT and MR imaging features of uCHS have no obvious specificity, but the examinations play important roles in depicting the location, internal structure and its correlation with the adjacent structures, as well as in formulating the plan of treatment and assessing the efficacy of treatment. The final diagnosis should be relied on pathologic and immunohistochemical examinations. |
| |
| Keywords: | |
|
| 点击此处可从《中华全科医学》浏览原始摘要信息 |
|
点击此处可从《中华全科医学》下载全文 |
|
