原发性软骨肉瘤的CT表现与病理关系.pdf

实用医学影像杂志2010 年第11 卷第6 期 JPMI ，2010 ，Vol.11,No.6 ·369 · ·论著· 原发性软骨肉瘤的CT 表现与病理关系 李 军，李耀光，刘亚丽，牛邵瑜 （山西省壶关县人民医院CT 室，山西 壶关 047300） 【摘要】 目的 探讨原发性软骨肉瘤的CT 表现及其与病理的相关性。方法 17 例经手术病理证实的软骨肉瘤患者均行CT 平 扫，其中12 例又行CT 增强扫描。对所有患者的CT 表现了进行了回顾性分析并与病理相对照。结果 17 例软骨肉瘤患者中，普通型 13 例，间质型2 例，透明细胞型及去分化型各1 例。发病部位包括股骨远端5 例，股骨近端3 例，髂骨4 例，肩胛骨、肱骨远端、尺骨、 腰椎、耻骨各1 例。膨胀性骨质破坏和溶骨性骨质破坏分别见于5 例和11 例。肿瘤有扇贝状分叶边缘13 例，瘤内钙化17 例。肿瘤 CT 值等于或低于肌肉CT 值，CT 增强显示小叶分隔呈弓环状进行性持续强化，小叶自身不强化。结论 扇贝状分叶边缘和弓环状进 行性强化是各型软骨肉瘤共有的特征性CT 表现，对诊断本病具有重要价值。 【关键词】 软骨肉瘤；体层摄影术，X 线计算机；增强扫描；病理学 【中图分类号】R814.42; R738.3 【文献标识码】A 【文章编号】1009- 6817 （2010）06- 0369- 03 CT findings of primary chondrosarcomas and their correlation with pathology Li Jun, Li Yaoguang, Liu Yali, Niu Shaoyu. CT Divi－ sion, Shanxi Provincial Huguanxian Peoples Hospital, Huguanxian 047300, China 【Abstract 】 Objective To study the CT findings of primary chondrosarcoma (PCS) and their correlation with pathology. Methods Seventeen patients with surgically and pathologically proved PCS underwent plain CT scans. Twelve patients underwent additional contrast- enhanced CT scans. CT findings of all patients were retrospectively analyzed and compared with pathologic findings. Results Among 17 PCS patients, conventional pattern was found in 13 cases, mesenchymal pattern in 2, clear cell-and dedifferentiated pattern in 1 each. The locations of PCS included distal femur (n=5), proximal femur(n=3),ilium(n=4), shoulder-blade, proximal humerus,ulna, lumbar spina and pu － bis(n=1 each). PCS appeared as expansive bone destruction(n=6) and lytic bone destruction(n=11). Tumors had scallop-like lobulated