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CT与MRI增强扫描对 透明细胞软骨肉瘤 诊断的对比研究

作者:赵德政1 郭 潆2

所属单位:1.河南省人民医院介入手术室 (河南 郑州 450003) 2.河南省人民医院CT室 (河南 郑州 450003)

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摘要

目的 对比CT与MRI增强扫描在透 明细胞软骨肉瘤中的诊断价值。方法 回 顾本院2015年5月-2017年5月就诊的94例 疑似透明细胞软骨肉瘤患者资料,随机分 为对照组47例,进行CT增强扫描;研究 组47例,进行MRI增强扫描。对比两组的 透明细胞软骨肉瘤确诊情况,透明细胞软 骨肉瘤的部位及形态、增强扫描征象。结 果 经检查,对照组有透明细胞软骨肉瘤 7例,研究组有透明细胞软骨肉瘤5例。两 组透明细胞软骨肉瘤均以股骨居多,形态 基本以叶状为主。对照组和研究组的透明 细胞软骨肉瘤均以溶骨性破坏、点状钙 化为主;对照组存在6例不均匀分隔状强 化,研究组5例都有不均匀分隔状强化。 结论 CT与MRI增强扫描在透明细胞软骨肉 瘤的临床诊断中均有明显的诊断价值,可 根据患者的实际情况灵活应用,提高诊疗 水平。

Objective To compare the diagnostic value of enhanced scanning of both CT and MRI in clear cell chondrosarcoma (CCCS). Methods The clinical data of 94 cases of suspected CCCS in our hospital from May 2015 to May 2017 were retrospectively analyzed. And patients were randomly divided into control group with CT enhanced scanning (n =47) and study group with MRI enhanced scanning (n=47). The diagnosis of CCCS, the location and morphology of CCCS lesions, and the scan signs were compared. Results The examination showed that there were 7 cases of CCCS in the control group and 5 cases in the study group. The lesions were mostly in femur, and were mostly presented with leaf shape. In both the control group and the study group, the CCCS were mainly dissolving bone destruction and punctate calcification. There were 6 cases of uneven separation enhancement in the control group and 5 cases in the study group. Conclusion CT and MRI enhanced scanning in the diagnosis of CCCS achieve obvious diagnostic value. The application is flexible according to the actual situation of patients, which can improve the diagnosis and treatment level.

【关键词】CT;MRI;透明细胞软骨肉 瘤;诊断价值

【中图分类号】R814.42;R445.2;R738.2

【文献标识码】A

【DOI】10.3969/j.issn.1672- 5131.2018.05.039

前言

透明细胞软骨肉瘤是一种少见的肿瘤亚型,恶性程度介于Ⅰ-Ⅱ 级,好发于股骨近端、肱骨近端、短骨的骨骺或骨突等,病变原因尚 不明确[1]。本病肉眼常为红色或血色,有时有颗粒状骨样物质;镜下 检查可见肿瘤成叶状组织,透明细胞核位于中心[2]。本病极少转移, 临床症状多表现为关节疼痛、关节活动受限、局部肿块等,患病人群 多见于30~70岁,男性发病率高于女性[3]。临床治疗透明细胞软骨肉 瘤,通常以手术治疗为主,但术后复发率较高,且临床鉴别诊断具有 相当的难度,除早期的X线表现为明显的溶骨界限区外,既往影像学检 查均无典型表现[4]。随着影像学技术的不断提高,放射线检查不仅可 以对多种疾病进行治疗,还可提高诊断水平,其中以CT检查与磁共振 成像(Magnetic Resonance Imaging,MRI)运用最为广泛[5]。因此,本 文选择部分疑似透明细胞软骨肉瘤的患者进行对比研究,现将结果报 道如下。