Ewing肉瘤75例分析

Ewing's Sarcoma: Analysis of 75 Cases

目的：探讨Ｅｗｉｎｇ肉瘤在不同骨部位，其放射学表现的异同点。材料与方法：对经证实的７５例Ｅｗｉｎｇ肉瘤的临床和放射学资料进行回顾性复习。结果：①长管骨：病变易沿骨长轴扩展，范围较广泛，常呈虫噬样或朽木样改变，骨膜反应较明显，常呈多层状或葱皮样；可有轻微膨胀；软组织肿块多不明显并多限于骨膜鞘下；②扁骨：溶冰状骨破坏常较局限，边缘不清，骨膜反应不明显，骨外软组织肿块较大，以及易侵犯邻近骨和关节。管状骨和扁骨等其他骨共同的骨改变是病变区的骨密度，均可分为单纯溶骨型、硬化型和混合型。结论：Ｅｗｉｎｇ肉瘤在不同骨部位有不同的Ｘ线表现，同时也有相同的骨密度改变，Ｅｗｉｎｇ肉瘤缺乏共同的典型的Ｘ线表现。

Objective: To discuss the similar and different radiological findings of Ewing's sarcoma in different bone sites.Materials and Methods:The clinical and radiological appearances of 75 patients with confirmed Ewing's sarcoma were reviewed retrospectively.Results:①Tubular bone: The Xray findings were: lesions proliferated easily along the longitudinal diffusion with a widespread extent, presenting as motheatenlike or rottenwoodlike destruction with a distinctive periosteal reaction, often laminated or onionpeel pattern, expansive slightly of the ill bone, soft tissue mass unclear, confined under the periosteal sheath usually; ②Flat bone: The findings were: poorly demarcated, relatively limited crackedicelike bone desturction with a undistinctive periosteal reaction and a large tumor mass, erosing the neighboring bones and joints easily. The same bone changes of all tubular and flat bones and other shape bones were that the bone density could be classified into three patternss: Osteolytic, osteosclerotic and mixed type.Conclusion: The different bone sites (such as tubular or flat bone etc) had different Xray signs, and also shared common changes of bone density; while Ewing's sarcoma has lacked general character of the Xray appearance.