X线、CT及MRI对骨肉瘤的诊断价值

目的:探讨X线平片、CT和MRI检查在骨肉瘤的临床诊断价值.方法:回顾分析18例经穿刺或手术病理证实的骨肉瘤的X线、CT和MRI表现,并加以总结.结果:本组18例,X线平片检查漏、误诊3例(其中2例表现阴性);18例中,CT检查显示骨肉瘤的瘤骨、骨质破坏优于X线平片11例;18例中,10例行MRI检查,均表现为骨髓腔内正常的骨髓高信号被肿瘤组织所取代,肿瘤周围骨髓和软组织内均可见水肿区,6例可见骨膜反应,3例中央发生坏死囊变.结论:X线检查简便、易行,其空间分辨率高,是诊断骨肉瘤的首选方法.CT对显示结构复杂、重叠部位较多的骨肉瘤病灶有明显优势.MRI扫描在判断肿瘤的范围方面有较大优势,并能为临床定制治疗方案及预后判断提供准确的依据.X线平片、CT和MRI检查三者结合应用,有利于提高对骨肉瘤的诊断准确性.

X-ray,CT and MRI Diagnostic Value for Osteosarcoma

Objective：To discuss the clinical diagnostic value of X-ray,CT and MRI for osteosarcoma.Methods：The X-ray、CT and MRI manifestations of 18 patients who were confirmed osteosarcoma by surgery and pathology,were analyzed and concluded.Results：Within the 18 cases,3 cases were missed diagnosis and misdiagnosis（of which 2 cases were negative in X-ray）;The CT manifestations of 11 cases are better than X-ray in displaying neoplastic bone and bone destruction;the MRI manifestations of 10 cases display normal bone marrow cavity high ignal is replaced by tumor tissue,and edema can be seen in bone marrow and soft tissue around the tumor,with visible periosteum reaction in 6 cases and central necrosis cystic degeneration in 3 cases.Conclusions：X-ray examination is the preferred method for the diagnosis of osteosarcoma for convenience and higher spatial resolution.CT has great advantage in the edging of tumor for displaying osteosarcoma lesion with complex structures and providing accurate basis for the clinical more overlapping parts.MRI has advantage in judging the edge of tumor,and provides accurate basis for the clinical treatment and judgement of prognosis.Above all,Taking the X-ray、CT and MRI into combination,will improve the accuracy of osteosarcoma′s diagnosis.