髂骨尤文肉瘤的MRI诊断

目的:分析髂骨尤文肉瘤的MRI表现及其诊断价值,以期提高对其的认识。方法:回顾性分析经病理证实的6例髂骨尤文肉瘤MRI表现,并复习文献所见。结果:6例中5例位于髂骨翼,1例位于髂骨体部。同侧骶髂关节和髋关节未见受侵。5例局部有溶骨性骨质破坏,1例髓腔硬化明显。骨皮质部分消失破坏,边缘毛糙。1例有针状骨膜反应。在病变髂骨前后均见巨大软组织肿块包绕,6例软组织肿块中均可见线样低信号间隔。结论:髂骨尤文肉瘤MRI表现缺乏特征性,但当髓腔和骨皮质出现广泛的溶骨性破坏,同时又有针状骨膜反应及具有低信号间隔的软组织肿块,结合年龄和发病部位,应考虑到本病可能。MRI可敏感、确切地显示肿瘤对骨内、骨外侵犯的范围及其与邻近组织器官的关系,但显示钙化和骨膜反应不如平片和CT。

MRI Diagnosis of Ewing's Sarcoma in Ilium

Objective To analyze the MRI findings and values in the diagnosis of iliac Ewing's sarcoma,and improve the recognition of this rare disease.Methods MRI was performed in 6 patients with iliac Ewing's sarcoma,which were confirmed by pathology and the relevant documents were studied retrospectively.Results Five tumors arose in iliac wing,one in iliac body.All of them extended toward neither the sacrum nor the acetabulum.Five tumors presented as permeative lytic lesions with cortical destructions,one had sclerotic.One tumor had spiculae periosteal reaction.In 6 cases,the large soft-tissue masses with the line dark signal interval around the involved bones can be seen.Conclusion The imageing findings are non specific.To consider age and localization,it was highly indicative of Ewing's sarcoma that the tumor had the lesions in marrow and cortical,spiculae periosteal reaction,the large soft-tissue mass with the line dark signal interval.MRI allows accurate boundary of osseous lesion and possible local invasion of adjacent structures sensitively.MRI was inferior to CT and plain film in displaying periosteal reaction and calcification.