长骨成软骨细胞瘤的影像学

Imaging Features of Chondroblastoma of Long Bone

目的:分析长骨成软骨母细胞瘤的X线、CT和MR影像学表现,探讨其典型特征,以进一步提高诊断准确率。材料和方法:回顾性分析10例经手术及病理证实的长骨成软骨细胞瘤(股骨近端1例,股骨远端4例,胫骨近端4例,肱骨近端1例)的临床和影像学资料;患者平均年龄20.4岁(12～38岁),全部行X线摄片检查,9例行CT检查,4例行MR检查。结果:全部病变发生于骨骺处,其中3例累及干骺端。病变呈偏心性生长,8例呈膨胀性改变。X线上显示6例点状或斑片状钙化,5例骨性分隔,9例周围硬化缘;CT显示9例点状或斑片状钙化,3例骨性分隔,2例层状骨膜反应,3例软组织肿胀。4例MR检查显示病灶在T_1WI为等低信号,T_2WI为不均质高信号,其内见斑点状低信号,其中2例见骨髓水肿,未见软组织肿块。结论:长骨成软骨细胞瘤典型发生于骨骺区,偏心生长,常有内部钙化并伴有周边硬化缘;部分不典型者可累及干骺端,少数出现骨膜反应和软组织肿胀。CT和MRI可以帮助更好地显示上述典型和不典型表现,综合评价有助于正确诊断。

Purpose： To evaluate the imaging features of chondroblastoma of long bone. Materials and Methods： The clinical and pathologic data of chondroblastoma in 10 cases（mean age 20.4 years, range from 12-38 years） were collected and analyzed retrospectively. Chondroblastoma occurred in proximal femur （n = 1）, distal femur（n = 4）, proximal tibia（n = 4）, proximal humerus（n = 1） . All cases underwent X-ray examination, 9 cases with CT, and 4 cases with MR imaging. Results： The tumors all arised from the epiphysis, and three cases involved the epimetaphyseal region. The lesion was presented as round or oval eccentric-type bony destruction on x-ray film, with expansive change （in 8 cases）, with spotty and piece calcification （in 6 cases）, with bony separation （in 5 cases）, and with peripheral sclerosis （in 9 cases）. The lesion was presented on CT images with bony separation （3 cases）, layer periosteal reaction （2 cases）, and soft tissues swelling （3 cases） . The chondroblastomas （4 cases） were hypointensity on T1 WI and heterogenous hyperintensity on T2 WI, with spotty hypointensity in the lesion both on T1W and T2W image. There were surrounded by edema of bone marrow （2 cases）, and no soft mass. Conclusions： Typical features of chondroblastoma of long bone are arising from the epiphysis with eccentric-type bony destruction, with calcification and peripheral sclerosis in the lesion. Some atypical features of chondroblastoma are the epimetaphyseal region involved, mild periosteal reaction and soft tissues swelling. The correct diagnosis can be made with X-ray examination in combination with CT and MR imaging.