软骨母细胞型骨肉瘤的影像诊断

Imaging Diagnosis of Chondroblastic Osteosarcoma

目的:探究软骨母细胞型骨肉瘤的X线平片、CT及MRI表现和诊断要点。方法:回顾性分析2010年1月至2020年6月我院经病理证实的软骨母细胞型骨肉瘤18例患者的病历资料,分析其X线平片、CT及MRI表现。结果:X线平片和CT显示肿瘤骨(棉絮样瘤骨12例,象牙质样瘤骨3例,针样瘤骨3例)、瘤软骨钙化(沙粒状、斑点状钙化8例,环状、半环状钙化6例)、骨膜新生骨(葱皮状9例、线状5例、层状4例,其中形成Codman三角10例)、软组织肿块18例;全部病例均出现不规则形骨质破坏,边界模糊。14例MRI增强扫描显示肿瘤病灶呈边缘强化4例,不均匀的间隔强化6例,边缘强化及间隔强化4例。结论:肿瘤骨、瘤软骨钙化、肿瘤边缘强化及间隔强化,是软骨母细胞型骨肉瘤的影像特点。合理利用影像学检查,有助于提高软骨母细胞型骨肉瘤的诊断准确率。

Objective: To explore the X-ray plain film, CT and MRI manifestations and diagnosis points of chondroblastic osteosarcoma. Methods: The medical records of 18 patients with chondroblastic osteosarcoma confirmed by pathology from January 2010 to June 2020 in our hospital were retrospectively analyzed, and their X-ray films, CT and MRI findings were analyzed. Results: X-ray plain film and CT showed tumor bone(12 cases of cotton wool-like tumor bone, 3 cases of dentin-like tumor bone, 3 cases of needle-like tumor bone), tumor cartilage calcification(8 cases of sand-grain and spot-like calcification, circular and semi 6 cases of circular calcification), periosteal new bone(9 cases of onion skin shape, 5 cases of linear shape, 4 cases of lamellar shape, including 10 cases of Codman triangle formation), 18 cases of soft tissue masses;irregular bone destruction occurred in all cases with blurred boundaries. MRI enhanced scans of 14 cases showed that 4 cases of tumor lesions showed edge enhancement, 6 cases of uneven interval enhancement, 4 cases of edge enhancement and interval enhancement. Conclusion: Tumor bone, tumor cartilage calcification, tumor edge enhancement and interval enhancement are the imaging features of chondroblastic osteosarcoma. Reasonable use of imaging examinations can help improve the diagnostic accuracy of chondroblastic osteosarcoma.