跟骨恶性肿瘤的影像诊断

目的总结跟骨恶性肿瘤的病理类型和影像特点,提高跟骨恶性肿瘤影像学诊断正确率。方法经手术病理证实的跟骨恶性肿瘤27例,全部患者均行X线摄片检查;CT检查20例,其中12例行增强扫描;MRI平扫+增强扫描18例,其中16行DWI检查。将全部影像检查资料进行回顾性分析。结果骨肉瘤8例,软骨肉瘤5例,纤维肉瘤及淋巴瘤和恶性骨巨细胞瘤各3例,尤文氏肉瘤和浆细胞瘤各2例,转移瘤1例。影像学表现为跟骨骨质破坏、瘤骨形成、骨膜异常、钙化、病理骨折及软组织肿块。结论(1)跟骨恶性肿瘤中骨肉瘤最常见。(2)跟骨恶性肿瘤影像学表现中以骨质破坏为主,瘤骨形成及骨膜异常、软组织肿块程度轻。(3)跟骨恶性肿瘤中,病理骨折多见且发生早,易合并出血。(4)跟骨恶性肿瘤的增强扫描中,跟骨内肿块与跟骨外软组织肿块强化程度一致。

The Imaging Diagnosis of Calcaneal Malignant Tumor

Objective To summarize the pathological types and imaging features of calcaneal malignant tumors,Further to increase the accuracy in imaging diagnosis.Methods Twenty-seven patients with calcaneal malignant tumor were enrolled in this study,which consisted of 19 male and 8 female aging from 9 to 72 years old with an average of 45years.X-ray plain films were obtained in all patients.CT scanning was conducted in 20patients,which included post-contrast scanning done in12.MR scanning was performed in 18 patients and DWI was done in 16 patients.All imaging findings was retropectively reeviewed carefully.Results It was found to include osteosarcoma(n=8),chondrosarcoma(n=5),fibrosarcoma or malignant hymphama or malignant giant cell tumor of bone(n=3),Ewing’s sarcoma,myeloma(n=2),metastatic tumor(n=1).The major manifestation was destruction of bone,tumor bone,periosteal anomaly,calcifcation,pathological fracture,soft tissues mass.Conclusion (1)Osteosarcoma is the most in all calcaneal malignant tumors.(2)Destruction of bone is first and tumor bone or periosteal anomally or soft tissues mass,et al is second in the manifestation of the calcaneal malignant tumor.(3)In imaging findings of the calcaneal malignant tumor,pathological fracture not only easily occur but also bleed.(4)The enhanced tumors are concordance thoroughtly in or out,when the calcaneal malignant tumoes are contrast-scanned.