骶骨神经源性肿瘤的X线平片及CT分析(附6例报告)

Radiological and CT Analysis of Neurogenic Tumors of the Sacrum: Report of 6 Cases

目的：通过分析骶骨神经源性肿瘤的Ｘ线和ＣＴ表现，提高其诊断水平。材料与方法：６例骶骨神经源性肿瘤，其中神经鞘瘤４例，恶性神经鞘瘤１例，神经纤维瘤１例。对其平片及ＣＴ表现进行分析。结果：平片表现：骶骨神经源性肿瘤多位于上部骶椎，偏侧性生长，骶孔或骶骨内压性扩大破坏或变形及多囊状膨胀溶骨性骨质破坏；边缘骨质硬化。ＣＴ表现：膨胀的溶骨破坏区被软组织肿块充填，骨壁变薄，肿块无钙化。肿瘤破坏骨壁或骶孔侵入软组织及邻近骨质时应考虑为恶性。结论：ＣＴ能提供平片不能显示的更多信息，疑有骶骨肿瘤时宜做ＣＴ检查。骶骨神经源性肿瘤要与骶骨脊索瘤、巨细胞瘤鉴别。

Objective: In order to diagnose more precisely.Materials and Methods: We analysed the plain films and CT findings of 6 neurogenic tumors of the sacrum. 6 cases including 5 neurilemmoma (1 with malignant change) and 1 neurofibroma.Results:Plain films: Most neurogenic tumors of the sacrum were eccentrically located on the upper part of the sacral vertebra. The sacral foramina, were enlarged and deformed, showed intrinsic pressure erosion and the body of the sacrum showed multilocular osteolytic bone destructions with marginal eburnation of the cystic lesions. CT: The osteolytic area of bone destruction were expansion and the walls of the bone were thinning. The destruction area was filled with soft tissue tumor without calcification. When the tumor mass had destroied the bone wall or sacral foramen, and invaded into the neighbouring soft tissue or bone, malignancy should be considered.Conclusion: CT could provide more diagnostic information than a single plain film. When a tumor of the sacrum would be suspected, CT should be recommended. Neurogenic tumors of the sacrum should be differentiated from chordoma and osteoclastoma.