摘要
目的 探讨扁骨成软骨细胞瘤CT 和MRI动态增强中的影像表现,提高对罕 见肿瘤的影像学认识。方法 系统性分 析经病理证实的8例扁骨成软骨细胞瘤 的多种影像学资料,分析其病灶位置、 形态、密度及CT/MRI增强表现等征象。 结果 8例入组病人中成软骨细胞瘤病灶 位于颅骨的5例,位于髌骨3例。病灶呈 不规则形,以膨胀性骨破坏为主,周围 可见完整或不完整的硬化缘,其内有或 无分隔,病灶内偶尔可见点状及片状钙 化。病灶MRI的增强影像主要表现为不均 匀混杂的T1、T2信号,增强呈明显不均 强化。结论 成软骨细胞瘤发生于扁骨 时,病灶膨胀,内见斑点状钙化,基质 明显强化为主要特征。由于病例较少, 为避免误诊,应结合临床、影像学和病 理学特征进行综合诊断。
Objective To explore the diagnostic imageological characteristics of chondroblastoma in flat bone. Methods Various imageological data from eight cases of pathologically confirmed flat bone chondroblastoma were systematically studied, where the features encompassing lesions position, morphology, density and performances of CT/MRI dynamic enhancement were analyzed. Results Five out of eight cases of chondroblastoma lesions were located on skull, the other three were located on patella. These lesions mainly appeared as rounded or irregular shapes with expansive osteolytic bone destruction under computerized tomography (CT) scan, represented noticeable holonomic or nonholonomic sclerosing margin with or without inner demarcation, and showed patchy or punctate calcification sporadically. The lesions also exhibited inhomogenous mixed T1 and T2 signals and remarkable uneven enhancements under Magnetic resonance imaging (MRI). Conclusion Chondroblastoma in flat bone was mainly featured as expansile lytic lesion with punctate calcification and stroma enhancement under both CT and MRI scan. Nevertheless, clinic, imageology and pathology should be comprehensively integrated for precise diagnosis considering the low incidence of Chondroblastoma in flat bone.
【关键词】成软骨细胞瘤;扁骨,CT扫 描;磁共振成像;
【中图分类号】R738.3;R445.2;R445.3
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2018.02.033
前言
成软骨细胞瘤(Cod man tumor),又名软骨母细胞瘤 (chondroblastoma,CB),是一种罕见的来源于软骨的原发性肿瘤,可 发生在任何软骨化骨的部位,常见于四肢长骨骨骺,而扁骨及不规则 骨则少见,容易引起误诊。本研究对我院2009~2015年入组的经病理 诊断确诊的成软骨细胞瘤患者的CT和MRI动态增强中的影像表现进行回 顾性分析,系统地探讨了该罕见病的影像表现特征及各种检查方法的 诊断价值,旨在提高对扁骨成软骨细胞瘤的认知。
中国CT和MRI杂志
第16卷, 第 2 期
2018年02月
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