骨肉瘤的X线CT及MRI检查分析

目的探讨骨肉瘤的X线、CT、MRI影像学表现。方法回顾分析2007年3月至2011年9月收治的骨肉瘤患者30例的影像资料,全部患者行X线检查,19例行CT检查,16例行MRI检查,全部经临床病理证实为骨肉瘤。结果 X线、CT、MRI检查诊断的准确率分别为88%、90%和94%。X线检查显示骨膜反应26例、瘤骨21例、软组织肿块20例、骨质破坏17例、Codman三角8例;19例CT检查均显示瘤骨、软组织肿块、骨质破坏,Codman三角3例,CT对Codman三角的显示率要低于X线检查;MRI检查显示骨髓腔明显肿瘤信号,T1WI低信号,T2WI混合信号,扫描可见肿瘤周围水肿,12例可见中央坏死囊变。结论 X线检查是骨肉瘤最常用的检查手段,CT对骨质破坏及微小瘤骨检查准确率更高,MRI高分辨率可以显示肿瘤浸润范围及周围组织情况,三者联合应用可以提高影像诊断的准确性。

Analysis of X-ray, CT and MRI examination in 30 cases of osteosarcoma

Objective To analyze imaging of X-ray,CT,MRI of osteosarcoma and analyze the diagnostic value.Methods The image data of 30 patients of osteosarcoma in our hospital from March 2007 to September 2011 were analyzed retrospectively.All patients were given X-ray examination,19 cases were given CT examination,16 cases were given MRI examination,all osteosarcomata were confirmed by clinical pathology.Results Diagnostic accuracy of X-ray,CT,MRI examination was 86.7%,89.5%,and 93.8% retrospectively.X-ray examination showed periosteal reaction in 26 cases,bone tumors in 21 cases,soft tissue mass in 20 cases,bone destruction in 17 cases,Codman triangle in 8 cases;19 cases of CT examination all showed tumor of bone,soft tissue mass,bone destruction,Codman triangle in 3 cases,and the rate of Codman triangle showed in CT was lower than that in X-ray;MRI examination showed significant tumor signal in the bone marrow cavity,T1WI low signal,T2WI mixed-signal,edema was showed surrounding the tumor,and central cystic necrosis in 12 cases.Conclusion X-ray examination is the commonest inspection method of osteosarcoma,and the accuracy rate of CT in small tumor and bone destruction is higher.High-resolution MRI can show the invasion scope and surrounding tissue.A combination of X-ray,CT and MRI examination can improve diagnostic accuracy.