软骨肉瘤的X线诊断

经手术、病理证实的174例软骨肉瘤中,中心型138例,周围型36例。中心型(原发性)重要的侵袭性X线征是:皮质内缘弥漫性浸润或呈扇形吸收变薄;肿瘤的滑干侧边缘不规则、模糊;过渡区增宽或见虫噬样破坏;偏一侧或绕骨干生长的软组织肿块;肿瘤内的各种钙化以及局限性骨膜反应。周围型(继发性)的X线表现:软骨帽变混浊,增厚(超过1cm);软组织肿块形成,其内有淡的环状或绒毛状钙化;软骨帽深层原钙化灶如“爆炸”样分散及邻近骨质破坏。

RADIOLOGIC DIAGNOSS OF CHONDROSARCOMA

One hundred and seventy-four cases of chondrosarcoma including central 138 and peripheral 36 proved by surgery and pathology are ana- lysed. The important aggressive X-ray hallmarks of central (primary) chondrosarcoma are: infiltrating, notching and scalloping of the endo- steal cortical surface; irregular and ill-defined margins between tumor and bone; a broad transition zone or "moth-eaten" areas; a tumor mass growing concentrically or eccentrically around the bone; various cal- cification within the tumor and limited laminated periosteal reaction. The radiologic features of the secondary peripheral chondrosarcoma are a fuzzy and indistinct surface in the regio nof the cartilaginous cap which then becomes irregular and thick (more than 1cm); formation of a soft tissue mass containg faint flocculent or ring-like calcification; the initial older calcifications frequently far removed from the calci- fied basal part deep to the cartilage cap; and destruction of the adj- acent bone.