原发性软骨肉瘤影像表现分析

The imaging analysis of the primary chondrosarcoma

目的探讨原发性软骨肉瘤的影像表现，提高对本病的诊断水平。方法回顾分析11例经病理确诊原发软骨肉瘤临床及影像学资料。结果11例患者年龄范围13～63岁，中位年龄41岁，其中40岁以上7例。10例行x线平片检查，表现为溶骨/混合性骨质破坏，5例病灶内见钙化，仅1例见骨膜反应；3例行CT检查，病灶内均可见环一弧状钙化及骨内膜“扇贝样”压迹；9例行MRI平扫＋增强检查，T2WI上以高信号为主，内可见低信号间隔，部分病灶内散在斑片状钙化低信号影，增强后病灶均呈较明显的弓一环形强化；其中3例行动态增强扫描，表现为早期明显强化。结论原发性软骨肉瘤具有一定的特征，综合分析影像表现可提高本病诊断及鉴别诊断水平。

Objective To study the imaging characteristics of primary chondrosarcoma in order to improve the level of di agnosis. Methods The clinical materials and image finding of chondrosarcoma were retrospectively analyzed in 11 cases proved by pathology. Results The age of the patients ranged from 13 to 63 years （median=41 years）. 10 patients were examined with X-ray, radiographs revealed osteolytic or mixed bone destruction, calcification were seen in 5 cases, the periosteal reaction was found in only 1 case. 3 cases had CT scan, ring and arc calcification and endosteal scalloping were detected in all the cases. 9 cases had undergone plain and enhanced MRI scan, all of them showed high signal intensity on T2Wl, with low signal intensity septa, marked hypointense loci were found in some lesions, all lesions demonstrated sig nificantly ring-arc enhancement after contrast material administration. MRI dynamic contrast-enhanced imagines were per formed in 3 cases, all of them manifested early obvious enhancement. Conclusion The imaging findings of primary chon drosarcoma have certain characteristics, a comprehensive analysis of radiological manifestations can improve the diagnosis and differential diagnosis of this disease.