骶骨肿瘤的影像学表现分析

目的分析骶骨肿瘤的影像表现,以期进一步提高对该部位肿瘤的认识。方法回顾性分析69例经病理证实的骶骨肿瘤的影像表现。58例行X线检查,32例行CT检查,47例行MRI检查。结果 69例骶骨肿瘤中,转移瘤23例,脊索瘤22例,神经源性肿瘤9例(神经鞘瘤7例、神经纤维瘤、神经母细胞瘤各1例),骨髓瘤6例,淋巴瘤及骨巨细胞瘤各3例,甲状腺滤泡癌、恶性纤维组织细胞瘤及韧带状纤维瘤各1例。骶骨恶性肿瘤表现为骶骨溶骨性骨质破坏,软组织肿块及骶髂关节受侵犯易见。脊索瘤表现为中心性、溶骨性骨质破坏,骨巨细胞瘤多为偏心膨胀性骨质破坏,转移瘤、骨髓瘤及淋巴瘤为多骨多发病变;神经源性肿瘤多伴有骶孔扩大、破坏。结论骶骨肿瘤的种类繁多、影像表现多样,结合病变的临床及影像学表现,可提高病变的诊断率。

The Image Analysis of Sacral Tumors

Objective To study the imaging appearances of sacral tumors,in order to improve the diagnostic accuracy.Methods The images of 69 cases were reviewed.All cases are confirmed by pathology.All of 58 cases underwent X-ray examinations,and 32 cases were examined by CT and 47 cases by MRI.Results Among 69 cases of sacral tumors:23 cases were metastatic tumors;22 cases were chordomas;9 cases were neuromas(including 7 cases of neurilemmoma,1 case of Neurofibromatosis and 1 case of neuroblastoma);6 cases were myeloma;Lymphoma and giant cell tumors had 3 cases respectively;Thyroid follicular carcinoma,malignant fibrous histiocytoma and desmoplastic fibromas had 1 case respectively.The image appearance of malignant tumors of sacrum were soft masses and osteolytic bone destruction,and the sacroiliac joint was easily to be invaded.The osteolytic bone destruction of chordoma was central type,while the giant cell tumor of bone was centrifugal.Multiple bone destruction was the feature of metastatic tumor,lymphoma and myeloma.The feature of neuroma was bone destrution with sacral canal destruction or enlargement.Conclusion The sacral tumors are variety,and the imaging appearances of these deseases are complex.Combining the clinical manifestation and images can improve the diagnosis of these diseases.