成软骨细胞瘤影像学诊断

目的 探讨成软骨细胞瘤影像学表现特点。资料与方法 分析22例经手术病理或穿刺活检证实的成软骨细胞瘤资料，总结其X线平片、CT和MRI表现。结果 胫骨上端18例，股骨下端2例，肱骨上端2例。表现为骨骺区分叶状骨质破坏区，内见钙化和更低密度区；MR T1WI以低信号为主，T2WI上信号混杂，扩散加权成像（DWI）上呈等高信号。硬化边厚薄不一。病灶周围在X线和CT上见高密度骨质硬化区，MRI表现为骨髓水肿。骨膜反应常不与病灶相邻，MRI上为长T1、短T2信号，与皮质间见条状高信号。邻近软组织肿胀，部分患者见关节积液。MRI上病灶可呈环状或较均匀强化，骨髓水肿、骨膜反应和软组织肿胀均强化。结论 成软骨细胞瘤影像学表现较有特征性，结合X线平片、CT和MRI能做出正确诊断。

The Imaging Features of Chondroblastoma

Objective To discuss the imaging features of chondroblastoma. Materials and Methods The X-ray, CT and MRI findings of 22 cases with chondroblastomas proved by pathology were analyzed.Results The lesions were located in the upper ends of tibias (n=18), the lower end of femurs (n=2), and the upper end of humeri (n=2). The chondroblastomas were presented with osteolystic destruction in bone with peripheral sclerosis, and were hypointensity on T_1WI, heterogenous intensity on T_2WI. They were surrounded by edema of bone marrow, which is hypointensity on T_1WI and hyperintensity on fat suppressed T_2WI and showed hyperdensity on CT. The adjacent soft tissues were swelling, and some patients had joint effusions. The periosteal reaction which were hypointensity on both T_1WI and T_2WI and hyperdensity on CT were always distant from the lesions. The lesions had ring like and relative homogeneous enhancement, and there were enhancement in areas of edema within bone marrow and adjacent soft tissue and periosteal reaction. Conclusion Chondroblastoma has characateristic imaging features, the correct diagnosis can be made with MRI in combination with X-ray and CT.