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目的:探讨骶骨和骶骨旁原发肿瘤影像学特点。材料与方法:回顾性分析了22例经手术病理证实的骶骨和骶骨旁的原发肿瘤,其中巨细胞瘤7例,神经鞘瘤4例,滑膜肉瘤5例,脊索瘤4例,软骨肉瘤及腹膜后丛状神经纤维瘤各1例。结果:(1)巨细胞瘤好发于年轻成人,常累及骶_(1～3),呈多房性膨胀骨质破坏;(2)神经鞘瘤表现为骶前正中圆形且轮廓锐利的肿块,瘤内有坏死囊变,部分囊内见液平,相应骶孔扩大;(3)骶骨旁滑膜肉瘤常呈分叶状肿块,于骶_(3～5)水平偏于骶骨一侧,有邻近骨质和肌群浸润;(4)骶骨脊索瘤常为骶_(3～5)中央性肿块,瘤内有不规则残余骨嵴或/和钙化;(5)瘤内大片钙化的软骨肉瘤和沿神经丛对称葡萄状分布的腹膜后丛状神经纤维瘤在影像上也各有特点。结论:骶骨和骶骨旁原发肿瘤的临床及影像学特点将有助于诊断和鉴别诊断。
Objective: To investigate the imaging features of primary tumors adjacent to the sacrum and sacrum. Materials and Methods: Twenty-two primary and metatarsal primary tumors confirmed by pathology were retrospectively analyzed. There were 7 cases of giant cell tumor, 4 cases of schwannoma, 5 cases of synovial sarcoma, 4 cases of chordoma, and chondrosarcoma. And 1 case of retroperitoneal plexus neurofibromas. Results: (1) Giant cell tumors occurred in young adults, often involving 骶_(1~3), and showed multi-atrial distended bone destruction; (2) schwannomas showed a round and sharp outline in the midline of the anterior ridge. Masses, necrotic cystic changes in the tumor, fluid levels seen in some of the capsules, corresponding to enlargement of the fistula; (3) sacral leiomyomas of the sacral side often present with lobulated masses, and tend to be on the side of the iliac _(3~5) level on the sacrum , there are adjacent bone and muscle infiltration; (4) sacral chordoma often 骶 _ (3 ~ 5) central mass, tumor with irregular residual bone callus or / and calcification; (5) large intratumoral calcification Chondrosarcoma and retroperitoneal plexus neurofibromas distributed along the plexus of the plexus also have features in the image. Conclusion: The clinical and imaging features of the primary bones of the humerus and humerus are helpful for diagnosis and differential diagnosis.