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·骨肌疾病·

单发型四肢长骨内生软骨瘤影像学诊断

作者:陈对梅 汪青山 陈文静 黄德干 汪 洋

所属单位:广东省第二中医院放射科 (广东 广州 510095)

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摘要

目的 探讨单发型四肢长骨内生软骨瘤的临床和影像学特征。方法 回顾性分析12例经手术病理证实的单发型四肢长 骨内生软骨瘤的临床和影像资料。结果 X线平片12例,分为三种表现:2例仅表现为钙化,1例仅表现为骨质破坏, 骨质破坏伴钙化9例。CT检查8例,所有病例均显示骨质破坏伴瘤内不同程度的钙化,CT显示小的骨质破坏及细微钙 化更有价值。MRI检查7例,所有病灶境界清楚,平扫T1WI呈低信号为主,1例病灶内见斑片状高信号,T2WI均呈不 均匀明显高信号,增强后4例病灶呈环形不均匀强化,3例呈斑片状不均匀强化。X线平片、CT及MRI图像所有病例均 未见骨膜反应及软组织肿块。结论 单发型长骨内生软骨瘤多具有典型的影像学特征,综合X线平片、CT和(或) MRI对本病大多数可做出定性诊断与鉴别诊断。

Objective To probe the clinic and imaging features of solitary enchondroma in long bone of limbs. Methods Clinic and imaging date of 12 patients with solitary enchondroma in long bone of limbs confirmed by surgical pathology were analyzed retrospectively. Results All patients had been underwent X-ray film. Calcification only in 2 cases, bone destruction only in 1case, and bone destruction with calcification in 9 cases. CT was performed in 8 cases and all cases showed bone destruction with varying calcification inside the lesions. CT was optimal to detect the minor destruction of bone and slight calcification. 7 cases were received MRI examination. All cases were hypointense on T1WI mainly, with stippling high signal intensity on T1WI in 1 case, and significantly high signal intensity on T2WI. On post contrast images, 4 cases showed “ring-and-arc” like heterogeneous enhancement and 3 plaque-like heterogeneous enhancement. There were no periosteal reaction and soft-tissue mass on all imaging finds. Conclusion Most of the solitary enchondroma in long bone of limbs had typical imaging features, the qualitative and differential diagnosis of which can be made mostly by X-ray film, CT and MRI.

【关键词】内生软骨瘤;X线摄影术;计算机断层扫描;磁共振成像

【中图分类号】R445;R738.3

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2016.02.022

前言

单发内生软骨瘤是一种来源于软骨内化骨的较常 见的良性骨肿瘤,最常累及手足的短骨状骨,其次为 四肢长骨。而国内针对长骨内生软骨瘤的X线、CT和 MRI三种影像方法综合分析的报道不多。笔者搜集我 院经手术病理证实的单发长骨内生软骨瘤12例患者的 影像资料,回顾性分析其X线、CT和MRI表现特征,以 期进一步提高对该病的影像诊断及鉴别诊断水平。