肋骨软骨肉瘤的X线、CT及MRI表现

X-ray, CT and MRI Detections of Chondrosarcoma of Ribs

目的 分析肋骨软骨肉瘤的X线、CT及MR表现,探讨有关的临床影像学特点和鉴别诊断。方法整理分析经手术与病理证实的13例肋骨软骨肉瘤患者临床、影像学资料,所有患者均行局部骨X线、CT和MR检查,其中5例经CT增强检查,对其影像学表现与病理结果进行对照,并由双盲法分析确认。结果 13例患者均为普通型中、高分化软骨肉瘤,10例发生于肋骨前缘肋软骨连接处,2例位于肋骨头,1例发生于肋骨中段。病灶【5 cm 4例,≥5~10 cm 8例,】10 cm 1例。所有病变均可见分叶状软组织肿块和点状、环状钙化。结论 肋骨软骨肉瘤在X线及CT上主要表现为溶骨性骨质破坏、分叶状软组织肿块和斑片状、弧形钙化,CT增强扫描肿瘤强化不明显,MRI对于显示软组织肿块的侵犯范围具有优势。

Objective To analyze the X-ray, CT and MRI findings of chondrosarcoma of ribs, and discuss the related clinic and radiology features and differential diagnosis. Methods The clinic and radiology features of 13 patients with chondrosarcoma of ribs confirmed by surgery and pathological examination were analyzed. All patients underwent the partial X-ray examination, CT and MR scan. The imaging signs of 5 cases undergoing contrast-enhanced CT scan were compared with the pathologic findings and confirmed by double blind method. Results All 13 patients were classified as well-differentiated and moderately-differentiated conventional chondrosarcoma. Ten cases occurred in anterior of ribs, adjacent to costal cartilage. Two cases occurred in the costal head. And one cases occurred in the middle of the rib. The diameters of the tumors ranged from 2.8 to 14.3 cm with 4 cases less than 5.0, 8 cases between 5.0 and 10 cm, and 1 case more than 10.0 cm. All tumors were with scallop-like soft tissue mass and 'ring and arc' mineralization. ConclusionChondrosarcoma of Ribs findings are bone destruction, lobulated masses and calcification in X-ray and CT. The value of enhancement CT is not obvious. MRI has great value for showing the size and range of the soft tissue masses.