恶性胸骨肿瘤CT诊断价值临床分析

Analysis on the diagnostic value of CT in diagnosing malignant tumor of sternum

【目的】分析探讨恶性胸骨肿瘤临床CT诊断价值和检查意义。【方法】搜集分析经临床病理证实的41例恶性胸骨肿瘤CT资料,其中胸骨转移性肿瘤37例(肺癌转移27例;乳腺癌转移7例;食道癌、前列腺癌及骨肉瘤转移各1例)。原发性胸骨肿瘤4例(骨髓瘤2例、软骨肉瘤1例、骨肉瘤1例)。【结果】胸骨局部骨质改变,其中溶骨性骨破坏26例(肺癌转移18例、乳腺癌转移5例、骨髓瘤2例、骨肉瘤1例)。成骨性骨破坏8例(肺癌转移6例、食道癌转移1例、骨肉瘤转移1例)。混合性骨破坏7例(肺癌转移3例、乳腺癌转移2例、前列腺癌转移1例、软骨肉瘤1例)。胸骨处软组织肿块21例,胸骨前胸壁肌、皮下脂肪和胸骨后脂肪间隙浸润17例,皮肤表面数个小结节状影突起2例。【结论】恶性胸骨肿瘤以转移瘤多见,CT检查对胸骨肿瘤有较高的诊断价值。

[Objective] To investigate the value of CT in diagnosing malignant bone tumor of sternum. [Method] 41 patients with malignant bone tumor in the sternum were confirmed clinically and pathologically, included metastasis tumor in 37 cases（from lung in 27, breast cancer in 7, and one each from esophagus cancer, prostate cancer and osteosarcoma ）, 4 cases with primary bone tumor in sternum （2 cases of myeloma,1 case of chondrosarcoma,1 case of osteogenic sarcoma）. [ Results]The local osseous changes of sternum, were osteolytic destruction in 26 cases （including 18 cases of metastatic tumor come from lung cancer, 5 cases of breast cancer, 2 cases of myeloma and 1 case of osteogenic sarcoma）.8 cases were osteoblastic destruction（including 6 cases of metastatic tumor come from lung cancer,1 case of esophagus cancer and 1 case of osteosarcoma ）.7 cases were mixed destruction of bone（including 3 cases of metastatic tumor come from lung cancer, 2 cases of breast cancer, l case of prostate cancer,1 case of chondrosarcoma）. 21 cases had mass of soft tissue in sternum, 17 cases were infiltration in the anterior muscles of sternum, subcutaneous fattissue and in the gap of the sternum nrear the fattissue and 2 cases with several nodular protrusion in the surface of skin. [Conclusion] Most malignant bone tumors of sternum are metastatic, CT is of great value in the diagnosis of bone tumor in the sternum.