骨肉瘤的X线，CT和MRI诊断分析

目的探讨骨肉瘤的X线、CT和MRI诊断价值，提高对原发性骨肉瘤的影像学认识。方法回顾53例经病理证实的原发性骨肉瘤的X线、CT或MRI检查资料。结果53例中经X线检查49例，正确率为89．8％；CT检查10例，正确率为90％；MRI检查32例，正确率为96．9％。骨肉瘤基本影像表现为骨质破坏、骨膜反应、瘤骨和软组织肿块。49例X线表现为成骨型19例，溶骨型13例，混合型17例；X线对骨质破坏、骨膜反应，软组织肿块、瘤骨和Codman三角的检出率分别为61．2％、95．9％、71．4％、73．5％和27．7％；10例CT表现均可见骨质破坏、软组织肿块及瘤骨，CT对骨膜反应、筛孔征和Codrnan三角的检出率为90％、90％和11％：CT对显示细小肿瘤骨和筛孔征最敏感，但对COdman三角的显示不如X线平片；32例MRI表现为骨髓腔内正常的骨髓高信号被肿瘤信号所取代，T1WI呈低～等信号，T2WI呈混杂信号，7例合并出血，24例中央坏死囊变，32例增强扫描均呈不均匀强化及瘤周可见水肿区。结论X线价廉物美，空间分辨力高，是骨肉瘤的首选检查方法，CT、MRI作为X线的补充，可以提供更丰富的诊断信息，对患者治疗方式的决策必须经MRI检查。X线、CT和MRI三者结合，可提高骨肉瘤影像诊断的准确性。

Analysis of X-Ray,CT and MRI in the diagnosis of osteosarcoma

Objective To approach the value of X-Ray, CT and MRI in the diagnosis of osteosarcoma and to improve the understanding level of primary osteosarcoma. Meth-ods Imaging of X-Ray, CT and/or MRI in 53 patients with primary osteosarcoma proved by pathology were reviewed. Results 49 patients were examined by radiography and the exact rate was 89.8%; 10 patients were examined with CT scan and the exact rate was 90%; 32 patients were examined with MRI scan and the exact rate was 96.6% rate. The fundamental imaging ...