骨肉瘤的X线、CT和MRI分析

Osteosarcoma:imaging findings on X-ray film,CT and MR

目的探讨骨肉瘤的X线、CT及MRI表现及诊断价值。方法对我院2009年3月～2013年3月诊治的22例原发性骨肉瘤患者的影像学资料进行回顾性研究,比较骨肉瘤X线、CT及MRI各自的表现及优点。结果 22例骨肉瘤患者,X线诊断19例,正确率为86.36%;CT诊断21例,正确率为95.45%;MRI诊断22例,正确率为100%。三种检查方法各具优势,X线能发现骨质破坏、骨膜反应、软组织肿块、肿瘤骨和Codman三角;CT在显示细小肿瘤骨和筛孔征方面有明显优势;MRI则能进一步观察到髓腔内肿瘤异常信号。结论 X线空间分辨率高,是检查骨肉瘤的首选方法;CT可以显示病灶的细微结构和组织变化;MRI能够准确界定肿瘤范围;将三者结合并优势互补,可为骨肉瘤的诊断提供更加可靠的影像学依据。

Objective To explore the findings of osteosarcoma on X-ray,CT and MR and their diagnositic value.Methods Imaging data of 22 pathologically confirmed osteosarcomas followed in our institution between March 2009 to March2013were analysed retrospectively and the respective findings and advantages on X-ray,CT and MR were compared.Results 22 patients with osteosarcoma,19 cases were diagnosed on X-ray and the accuracy rate was 86.36%;21cases were diagnosed on CT anhe accuracy rate was 95.45%.22 cases were diagnosed on MRI and the accuracy rate was 100%.These three methods had their own advantages.Bone destruction,periosteal reaction soft tissue mass,neoplastic bone and Codman triangle can be detected on X-ray.CT had advantages in detecting small neoplastic bone and sieve sign.Abnormal signal of osteosarcoma in medullary space can be further observed on MRI.Conclusion X-ray has high spatial resolution and it is the first examination choice for osteosarcoma.CT can display small changes of the structure and tissues.MRI can accurately define the scope of the osteosarcoma.More reliable evidence for imaging diagnosis of osteosarcoma can be provided with combination of three methods and their complementary advantages.