中药治愈骨肉瘤影像学特征研究

THE IMAGING SIGNS OF OSTEOSARCOMA CURED WITH CHINESE HERBAL MEDICINE

目的 研究中药治愈骨肉瘤后其影像学特征。方法 观察拒绝截肢采用中药治愈的9例骨肉瘤影像学表现，其中4例经活检病理证实，2例诊断骨肉瘤时肺部已发现转移，1例股骨成骨型骨肉瘤同侧胫骨骨骺内有成骨性转移，另外2例经影像学专家按举证倒置程序，论证骨肉瘤的影像学诊断，排除了其他病变的可能。追踪观察6～43年，分别进行X线随访6～23次，其中1例加行CT，2例加行MRI检查随访。结果 经中药治愈的病例随访中发现肿瘤破坏的结构、瘤骨等均有向正常骨转化过程，9例均在肿瘤外围新生骨性外壳（“骨墙”）；“骨墙”内均有成熟的骨小梁和骨嵴新生，8例破坏的骨皮质重新修复，5例“骨墙”内有钙化，2例髓腔内有钙化，1例“骨墙”内及髓腔内均有骨髓组织再生。结论 经中药治疗后的“骨墙”形成，可能是骨肉瘤治愈的影像学特征。

Objective To study the imaging features of cured osteosarcoma with Chinese herbal medicine. Methods The imaging features of nine patients who refused amputation and chose to be treated with Chinese herbal medicine were observed. Of the patients, four were confirmed pathologically, two were found to have pulmonary metastasis at diagnosis, one of femur osteogenic osteosarcoma with osteogenic metastasis was found in the epiphysis of the homolateral tibia, and the other two were proved to have no possibility of other diseases by radiological specialists to demonstrate the imaging diagnosis of osteosarcoma. All the cases were followed for six to 43 years and were X-rayed for 6-23 times, in which one was examined by CT, and two were by MRI. Those who were not cured or failed to be followed were excluded from this study. Results The cases cured had tumorous resto- ration and tumorous bone were transferred to normal bone. Nine cases had bone outer shell （＂skeletal wall＂）, in which, there were mature bone trabecula and newborn bone; eight cases had restoration of cortex; five had calcification in the ＂skeletal wall＂; two had calcification in the medullary cavity; one had regeneration of myelold tissue in the ＂skeletal wall＂ and medullary cavity. Conclusion ＂Skeletal wall＂ is probably an imaging feature of osteosarcoma which was cured by Chinese medicinal herbs.