骨盆原发性恶性肿瘤的影像学诊断

目的:探讨骨盆原发性恶性肿瘤的影像学诊断价值.方法:回顾性分析17例经病理证实的骨盆原发性恶性肿瘤的影像学表现.结果:17例骨盆原发性恶性肿瘤中,骨盆软组织来源10例,骨性骨盆来源7例.骨盆软组织来源者多位于臀部肌肉或肌间隙(7/10),骨性骨盆来源者多位于双侧髂骨或累及髂骨(5/7).5例显示钙化,其中软骨肉瘤2例,表现为多发环状及条状钙化,另外3例为平滑肌肉瘤、滑膜肉瘤及血管肉瘤,为散在少量点状钙化;11例表现为不均匀强化,4例实性部分明显强化,2例无明显强化;5例为囊实性,12例为实性.结论:骨盆原发性恶性肿瘤病理类型复杂,熟悉其影像学表现有助于提高术前诊断符合率,最终确诊仍需组织病理学.

Imaging diagnosis of pelvic primary malignant tumor

Objective：To study the diagnostic value of imaging for pelvic primary malignant tumor.Methods：Image findings of 17 cases of pelvic primary malignant tumor confirmed by pathology were analyzed retrospectively.Results：Among the 17 cases of pelvic primary malignant tumor,10 originated from pelvic soft tissues and 7 originated from pelvic bones.Most of the lesions originated from pelvic soft tissues were located in buttocks muscles or intermuscular space（7 cases,70%）,Most of the lesions originated from pelvic bone were located in ilium（5 cases,71.4%）.5 of 17 cases showed calcification,from which 2 cases were chondrosarcoma which showed circular or linear calcification,the other 3 cases were leiomyosarcoma and synovial sarcoma and angiosarcoma which showed scattered small calcifications.On contrast-enhanced images,11 cases showed heterogeneous enhancement,4 cases obvious enhancement in solid portion and 2 cases no enhancement.There were 5 cases presenting cystic solid mass,and 12 solid mass.Conclusion：The pathological type of pelvic primary malignant tumor is various.Familiarity of the features can help to improve preoperative diagnostic accuracy,the final diagnosis must depend on pathology.