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目的:探讨肋骨原发性软骨肉瘤的影像学特点。方法:收集经手术病理证实的12例肋骨原发性软骨肉瘤,回顾性分析其X线、CT及MRI表现。结果:12例肋骨原发性软骨肉瘤(男性6例,女性6例)。12例肋骨原发性软骨肉瘤位于肋骨前缘肋软骨连接处7例,位于肋骨头近胸椎处4例,肋骨腋段1例。X线检查均表现为境界清楚/密度均匀的胸部肿块(左侧7例,右侧5例),邻近肋骨骨质结构变模糊。CT平扫病变处均呈溶骨性、膨胀性骨质破坏,局部软组织肿块边缘清晰伴有条状、结节状及环状钙化。CT增强扫描病变(11例)强化不明显,邻近椎体和附件表现为骨质侵蚀破坏。10例肋骨原发性软骨肉瘤接受了MRI检查,病变均表现为边界清楚的长T1、长T2混杂信号肿块,增强后不均匀环状强化。结论:钙化为肋骨原发性软骨肉瘤的特征性表现,边界清楚的软组织肿块为重要征象,环状强化为其增强CT/MRI表现特点,完善影像学检查,能明显提高诊断的准确性,指导临床手术。
Objective: To investigate the imaging features of rib primary chondrosarcoma. Methods: Twelve cases of rib primary chondrosarcoma confirmed by surgery and pathology were collected. The X - ray, CT and MRI findings were retrospectively analyzed. Results: 12 cases of primary chondrosarcoma of ribs (6 males and 6 females). 12 cases of primary chondrosarcoma of the rib were located in the costal cartilaginous junction of the rib in 7 cases, located in the rib head near the thoracic vertebra in 4 cases, rib axillary in 1 case. X-ray examination showed a clear / uniform chest mass (7 on the left and 5 on the right), and the bone structure of the adjacent rib became blurred. CT plain lesions were osteolytic, expansive bone destruction, local soft tissue mass with clear edge of the strip, nodular and annular calcification. CT enhanced scan lesions (11 cases) were not significantly enhanced, adjacent vertebral bodies and appendages showed destruction of bone erosion. Ten cases of rib primary chondrosarcoma were examined by MRI. The lesions showed a long T1, long T2 mixed signal mass with a clear boundary, and an uneven circular enhancement after enhancement. CONCLUSION: Calcification is the characteristic manifestation of rib primary chondrosarcoma. Soft tissue mass with clear border is an important sign. Cyclic enhancement is the characteristic of enhanced CT / MRI. Perfecting imaging examination, it can obviously improve the accuracy of diagnosis. Clinical surgery.