骨纤维肉瘤的CT和MRI诊断

CT and MRI Diagnosis of fibrosarcoma of bone

目的 :评价CT和MRI在骨纤维肉瘤中的诊断价值。方法 :回顾性分析经手术病理证实的 7例骨纤维肉瘤的平片、CT和MRI表现。结果 :7例均为中央型 ,其中股骨 3例 ,胫骨 2例 ,肱骨 1例 ,肋骨 1例。影像学表现主要为无膨胀性骨质破坏 ,4例边界清楚 ,3例边界模糊。CT能清晰显示骨皮质的侵蚀、断裂以及骨内膜的虫蚀状破坏 ,1例CT见散在颗粒状钙化 ,1例可见较大软组织肿块 ,7例CT均未见到骨膜反应。 4例MRI检查T1WI上 3例均匀低信号 ,1例稍低信号欠均匀 ,T2 WI上随分化程度高低而不同 ,1例中心明显液性高信号 ,手术病理证实为坏死。结论 :CT和MRI对骨纤维肉瘤有较高诊断价值 。

Objective:To evaluate CT and MRI in the diagnosis of fibrosarcoma of bone.Methods:The features of CT and MRI of 7 cases of fibrosarcoma of bone proved pathologically were retrospectively reviewed.Results:All cases were central type.Tumor locations were the femur (n=3),tibia (n=2),humerus (n=1)and rib(n=1).The major manifestation was destruction of bone without expansion.The margin of the tumor was well defined in 4 cases and blurred in 3.Erosion of bone and destruction of endosteum could be clearly shown on CT.Scattered granular calcification was found in one case and obvious soft tissue mass in another.No case showed periosteal reaction of bone.In 4 cases who received MRI examination,homogenous low signal was seen in 3 cases and heterogeneous in one on T 1WI.Different signal intensity was shown on T 2WI, consistent with the degree of tumor differentiation.One case showed high signal in centre of the tumor and this was pathologically proved to be necrosis. Conclusion:CT and MRI has high value in diagnosis of fibrosarcoma of bone,but the appearances are not specific.