胸骨肿瘤的临床与影像学分析

Analysis of clinical characteristics and image for sternum tumor

目的：分析胸骨肿瘤的临床及影像学表现.方法：回顾性分析18例经手术或病理证实的胸骨肿瘤患者的临床及影像学资料,其中男13例,女5例;年龄24～73岁,平均58.3岁;11例保守治疗,7例手术治疗;病程2个月～6年.1例患者无明显症状,1例有胸部外伤史.18例患者经X线片、CT、MRI检查,观察骨质破坏形态、骨皮质改变、MRI信号异常、瘤周骨髓水肿以及增强强化等指标.结果：18例中恶性骨肿瘤16例,良性肿瘤2例;发生于胸骨柄7例,胸骨体9例,胸骨柄、体部均受累2例.影像学表现上,胸骨肿瘤具有膨胀性骨质破坏的倾向,15例骨质破坏区边界连续性或部分中断,2例骨皮质边缘毛糙、变薄,1例骨皮质增厚.7例行MRI检查均未见瘤周骨髓水肿,2例可见软组织侵犯;与邻近肌肉相比,4例T1WI表现为低信号,3例呈等、高信号,6例T2WI表现为等、高信号,1例混杂信号.MRI增强扫描,大部分病例表现为明显强化.结论：胸骨肿瘤种类多样,以恶性肿瘤居多;胸骨肿瘤的影像学表现大多缺乏特征性,结合临床表现,综合分析其X线、CT及MRI征象,有助于提高胸骨肿瘤的诊断准确性.

Objective：To analyze the clinical characteristics and imaging features of sternum tumor,in order to improve the knowledge of the diseases.Methods：The clinical data and imaging data of 18 patients with sternum tumor were retrospectively analyzed.There were 13 males and 5 females,aged from 24 to 73 years old with an average of 58.3 years.Eleven patients were treated by conservative treatment and 7 patients were treated by surgery.The course of disease ranged from 2 months to 6 years.One patient had no obvious symptoms and 1 patient had a history of chest trauma.Lesion location,pattern of bone destruction,cortical bone abnormality,MRI signal characteristics and contrast-enhancement were observed in the patients.Results：Eighteen cases included malignant bone tumor in 16 cases and benign tumor in 2 cases;and 7 cases located in sternal manubrium,9 cases located in sternal body,and 2 cases located in both.On the imaging,sternal tumor had expansively developing tendency,and the bone destruction zone boundary continuity or partial disruption occurred in 15 cases,the border of cortical bone thinning in 2 cases,the cortical bone increased thickness in 1 case.No bone marrow edema around tumor was found in 7 cases by MRI and soft tissues was encroached in 2 cases;in T1WI of MRI,4 cases showed the hypointense signal and 3 cases showed the iso-or hyper intensity signal;in T2WI of MRI,6 cases showed the iso-or hyper intensity signal and 1 case showed confounding signal.Enhancement scanning in MRI,premodinantly tumors showed obviously strengthening.Conclusion：The types of the sternum tumors are various and the most tumors are malignant.The images of the mostly sternum tumor absented same charactiristic,and it must combine with clinical manifestation to analyze the X-rays,CT scanning and MRI,it will conduce to improve the diagonstic accuracy of the sternum tumors.