颅底原发软骨肉瘤的影像学诊断:附5例报告

The Diagnosis of X-ray, CT and MRI of Primary Chondrosarcoma at Cranial Base

背景与目的:颅底原发软骨肉瘤临床少见.较易误诊,本文分析颅底软骨肉瘤的X线、CT和MRI表现并相互比较,探讨这几种影像学诊断方法对它的诊断价值及限度。方法:回顾性总结5例经手术病理证实的颅底原发软骨肉瘤,患者均进行了X线、CT和MRI检查(平扫和增强),2例行数字减影血管造影(DSA)检查。结果:5例X线平片均可显示不同程度的钙化及骨质破坏;CT则可清楚显示病灶的钙化及分布情况,骨质破坏显示良好,优于X线;MRI可全面显示病灶的范围及少量出血,优于X线与CT,但不能显示特征性的钙化。DSA仅显示血管受压移位,无特征性改变。结论:颅底原发软骨肉瘤的X线、CT表现有一定的特征性,X线提示病变,CT可明确诊断,MRI则可三维显示病变的范围,它们都是诊断颅底原发软骨肉瘤的有效方法。

BACKGROUND & OBJECTIVE: To analyze X-ray, CT and MRI features of primary chondrosarcoma at the cranial base, and to evaluate the value and limitation of X-ray, CT and MRI in its diagnostic ability by comparing imaging signs among the methods.METHODS: Five patients with pathologically-proved primary chondrosarcoma at the cranial base were collected.X-ray films, plain and enhanced CT and MRI were performed in all patients, DSA examination were taken in 2 cases.Imaging findings and follow-ups after operation were analyzed and compared.RESULTS: Bone destruction and calciiication of different degree was seen in 5 patients on X-ray films, CT can show the bone destruction and calcification more clearly than X-ray films, and MRI can show the extend of tumor more clearly in three-dimensional views than X-ray and CT, but was unable to show the characteristic calcification.DSA can only show the displacement of blood vessels without any characteristic findings.CONCLUSION: X-ray, CT can be characteristic of diagnosing primary chondrosarcoma at cranial base.MRI can show the complete extend of tumor in three-dimentional views.In summary, the 4 radiological modality are all effective imaging methods for the diagnosis of chrondrosareoma of the skull base.