骨端肿瘤的影像诊断

The imaging diagnosis of the bone ends tumors

目的探讨骨端肿瘤的影像诊断及鉴别诊断。方法对43例经手术病理证实的骺板闭合后侵及、接近关节面骨端肿瘤影像资料进行分析。结果巨细胞瘤11例,呈偏心性、膨胀性破坏,无硬化缘。内生软骨瘤2例,密度减低,可见斑点状钙化。骨样骨瘤3例,显示瘤巢,边缘硬化,可见钙化,病灶<2 cm。软骨母细胞瘤2例,骨质破坏内见斑点状、条状和片絮状钙化。纤维黄色瘤1例,呈溶骨性骨质破坏,MRI T1WI、T2WI均显示片状低及更低信号。骨母细胞瘤1例,呈广泛性高密度。骨肉瘤10例,骨转移瘤7例,诊断相对容易。软骨肉瘤4例,溶骨性破坏,病灶内出现斑点状钙化,软组织肿快。恶性纤维组织细胞瘤1例,溶骨性破坏,巨大软组织肿块。骨纤维肉瘤1例,不膨胀的囊状破坏,边缘不规则。结论影像表现对骨端肿瘤诊断及鉴别诊断有重要价值。

Objective To study the imaging features and diagnosic values of bone tumors in the end of bones. Methods Analysis for image datas of 43 patients with bone ends tumors after epiphyseal plate closure. Results Eleven cases of giant cell tumor, were eccentric, expansive destruction, no hardened edge. Enchondroma 2cases, density was reduced and showing punctate calcification. Three cases osteoid osteoma, showing nidus, edge hardening, calcification and lesions less than 2 cm. Chondroblastoma 2 cases, showing spots within the bone destruc-tion, strip and sheet flocculent calcifications. Fibrous yellow tumor 1 case, osteolytic bone destruction, MRI T1 WI,T2WI showed low and lower signal flake. Osteoblastoma 1 case, showed extensive high density. Ten cases of osteosar-coma, bone metastases 7 cases, the diagnosis were relatively easy. Chondrosarcoma 4 cases, osteolytic destruction,punctate calcification within the lesion appears and with soft tissue mass. Malignant fibrous histiocytoma 1 case, oste-olytic destruction and with huge soft tissue mass. Conclusion Imaging findings of bone ends tumors are important values of diagnosis and differential diagnosis.