肋骨原发性软骨肉瘤的影像表现

The Imaging Findings of Primary Chondrosarcoma of Ribs

目的:探讨肋骨原发性软骨肉瘤的影像学特点。方法:收集经手术病理证实的12例肋骨原发性软骨肉瘤,回顾性分析其X线、CT及MRI表现。结果:12例肋骨原发性软骨肉瘤(男性6例,女性6例)。12例肋骨原发性软骨肉瘤位于肋骨前缘肋软骨连接处7例,位于肋骨头近胸椎处4例,肋骨腋段1例。X线检查均表现为境界清楚/密度均匀的胸部肿块(左侧7例,右侧5例),邻近肋骨骨质结构变模糊。CT平扫病变处均呈溶骨性、膨胀性骨质破坏,局部软组织肿块边缘清晰伴有条状、结节状及环状钙化。CT增强扫描病变(11例)强化不明显,邻近椎体和附件表现为骨质侵蚀破坏。10例肋骨原发性软骨肉瘤接受了MRI检查,病变均表现为边界清楚的长T1、长T2混杂信号肿块,增强后不均匀环状强化。结论:钙化为肋骨原发性软骨肉瘤的特征性表现,边界清楚的软组织肿块为重要征象,环状强化为其增强CT/MRI表现特点,完善影像学检查,能明显提高诊断的准确性,指导临床手术。

Objective： To explore the imaging characteristics of primary chondrosarcoma of ribs. Methods： Collected pathologically confirmed 12 cases of primary chondrosarcoma of ribs, retrospectively analyzed the X-ray, CT and MRI. Results： 12 cases of primary chondrosarcoma of ribs with 6 cases of male and female 6 cases. 12 cases of primary chondrosarcoma of ribs located in Costa rib cartilage junction 7 cases, rib bones is located near thoracic vertebra in 4 cases, rib axillary segment in 1 cases, X-ray examination showed for the realm of clear /uniform density of breast lumps（left side in 7 cases and 5 cases of right） and adjacent rib bone structure fuzzy variable. CT scan lesions were osteolytic and expansive bone destruction, local soft tissue mass with clear edge accompanied by the strip, nodular and annular calcification, enhanced CT scan which the lesions（11 cases） no obvious enhancement, adjacent vertebral body and appendix performance for bone erosion damage. 10 cases of primary chondrosarcoma of ribs received MRI examination, Lesions showed as clear boundary long T1 and long T2 mixed signal mass, which enhanced orbicular heterogeneous enhancement. Conclusion： Calcification is the characteristic of primary chondrosarcoma of ribs, boundary clear mass lesion is vital signs, ring strengthen for their enhanced CT/MRI performance characteristics, perfect imaging examination can significantly improve the accuracy of diagnosis and guide the clinical surgery.