颌面部骨肉瘤的CT和MRI特征分析

CT and MRI findings of maxilloficial osteosarcoma

目的:探讨发生于颌面部骨肉瘤的CT和MRI特点。方法:回顾性分析33例经临床病理证实的颌面部骨肉瘤的CT及MRI表现(男21例,女12例),其中2例有面颈部射线接触史,1例有骨纤维结构不良病史。结果:33例患者均表现为不同程度的颌面部肿胀伴局部疼痛,其中19例发生于下颌骨、9例发生于上颌骨、3例发生于筛窦、2例发生于颧骨。33例CT检查提示骨肉瘤,其中18例另行MRI检查均提示骨肉瘤。影像表现为成骨性改变17例,溶骨性骨质破坏6例、混合性改变10例。14例可见放射状骨膜反应、2例可见针状骨膜反应。4例侵犯眼眶、2例侵及颅内。MRI具有更好的软组织分辨力,能更清楚显示肿瘤与邻近组织结构的关系。所有病例均行手术切除,随访发现12例患者于术后局部复发。结论:CT及MRI均可对颌面部骨肉瘤提供明确的影像学诊断依据。

Objective: To analyze CT and MR imaging characters of osteosarcoma in the maxillofacial region. Methods:CT and MR imaging features of 33 patients(21 males and 12 females) were retrospectively studied. 2 patients had a history of radiation exposure, 1 had a history of osteofibrous dysplasia. Results:All the lesions presented as soft tissue mass with local pain. The lesions of 19 pa tients affected mandible, 9 affected maxilla, 3 affected ethmoid sinuses and 2 affected malar bone. 33 cases underwent CT examination and 18 of them were given additional MRI test. The lesions demonstrated osteogenesis changes in 17 cases, osteolytic in 6 cases and mixed changes in 10 cases. 14 patients were found with radial periosteal reaction and 2 with acicular periosteal reaction, 4 with orbital involvement and 2 with invasion into the frontal lobe of the brain. Local recurrence was observed in 12 cases during 3-10 month fol lowed up. Conclusion: CT and MRI imaging may provide image evidence for the diagnosis of maxillaficial osteosarcoma.