软骨母细胞瘤MRI及X线平片和CT的表现特征

目的 研究软骨母细胞瘤的影像表现,探讨其MRI与X线平片、CT征象的对应关系.方法 分析16例经手术、病理证实的良性软骨母细胞瘤的影像资料,总结其MRI表现与X线平片、CT征象的对应关系.结果 16例软骨母细胞瘤均位于骨骺,大小为0.9 cm×0.8 cm×1.0 cm～4.8 cm×4.3 cm×5.1 cm,呈不同程度的分叶状.在T1WI上以等、低信号为主,T2WI上呈混杂信号,CT上为软组织密度,内见钙化和更低密度区.边缘呈长T1、短T2信号,在CT上表现为硬化边.MRI可见病灶周围有骨髓水肿,在X线和CT上表现为骨质硬化区.病灶邻近软组织肿胀.MRI显示骨膜异常9例,8例与病灶不相邻;X线和(或)CT显示骨膜新生骨6例.MRI显示关节积液12例,CT显示6例.MRI上病灶均呈不均匀强化,骨髓水肿、骨膜反应和软组织肿胀均见强化.软骨母细胞瘤在扩散加权成像(DWI)上呈等、高信号,在MR平扫中的等T1、等T2成分和长T1、长T2成分,以及骨髓水肿、骨膜反应和软组织肿胀在DWI上均呈高信号.结论 MRI和X线平片、CT从不同方面反映软骨母细胞瘤的病理改变,联合应用不同检查手段可更全面显示软骨母细胞瘤的特点.

The MRI features of chondroblastoma with correlation of X-ray and CT findings

Objective To investigate the MR imaging features of chondroblastoma,and to address the correlation with findings of X-ray radiography and CT.Methods The imaging findings including MRI,X-ray radiography and CT of 16 chondroblastomas proved by surgery and pathology were analyzed and correlated with each other. Results All sixteen chondroblastomas involved the epiphyses of long bones,with varying sizes from 0.8 cm to 5.1 cm and lobulation. They were iso- and hypo-intense on T1WI and had heterogeneous signals on T2WI.They were of soft tissue density on CT,and had areas of calcifications and low density.The rims were hypointense on both T1 WI and T2 WI and showed hyperdensity on CT. The lesions were surrounded by edema of bone marrow which was hypointense on T1 WI and hyperintense on fat suppressed T2WI,while on X-Ray film and CT it was hyperdense sclerotic area.The adjacent soft tissues were swelling.Nine cases had periosteal abnormalities on MRI in which 8 of 9 periosteal abnormalities were distant from the primary lesions,and 6 of them showed hyperdense perosteal new bone on CT.Twelve cases had joint effusion on MRI and CT detected 6 of them.The lesions had heterogeneous enhancement,and there was enhancement in areas of edema within bone marrow,periosteal reaction and adjacent soft tissue.Chondroblastoma was intermediate and hyperintense on DWI,and the intermediate areas on both T1 WI and T2WI,together with areas of bone marrow edema,periosteal reaction and soft tissue swelling,were hyperintense on DWI.Conclusions The MRI,X-ray and CT can reflect the pathological changes of chondroblastoma from different aspects.The characteristics of chondroblastoma can be better appreciated by combining different imaging methods.