骨血管肉瘤的CT、MRI征象分析

Analysis of the Symptoms of CT、MRI in Osteoangiosarcoma

目的探讨骨血管肉瘤的CT和MRI征象。方法搜集2005年7月至2017年8月14例(男女比1∶1,平均年龄45.8岁)手术病理证实的骨血管肉瘤术前CT、MRI资料进行回顾性分析,包括判定病灶生长方式、内部成分、边缘、软组织肿块、强化方式等。结果病灶位于脊柱5例(胸椎3例,颈椎、骶椎各1例),呈溶骨性骨破坏,骨皮质受侵,形成软组织肿块。全身各骨广泛破坏者3例,累及椎体者可见大块反应性骨硬化。位于长骨者3例,其中2例为溶骨性破坏,1例为巨大膨胀性骨破坏。位于骨盆者2例,顶骨1例,均不伴硬化边。MRI扫描较大肿块内有出血,增强扫描呈边缘强化或向心性强化。结论骨血管肉瘤表现多样,好发于椎体和长骨,若出现反应性骨硬化和MRI增强扫描向心性强化有助诊断。

Objective To investigate the CT and MRI signs of osteosarcoma. Methods A retrospective analysis of preoperative CT and MRI data of 14 cases(men and women ratio 1:1, mean age 45.8 years) confirmed by surgical pathology from July 2005 to August 2017 was performed, including the determination of lesion growth pattern and internal Ingredients, edges, soft tissue masses, strengthening methods, etc. Results The lesions were located in the spine in 5 cases(3 cases of thoracic vertebrae, 1 case of cervical vertebrae and atlanto-vertebral vertebrae). The osteolytic bone was destroyed and the cortical bone was invaded to form a soft tissue mass. There were 3 cases of extensive bone destruction in the whole body, and large reactive bone sclerosis was seen in the vertebral body. There were 3 cases of long bones, 2 of which were osteolytic destruction and 1 case of massive expansive bone destruction. There were 2 cases in the pelvis and 1 case in the parietal bone, all without hardening. MRI scans for larger masses with hemorrhage, and enhanced scans with marginal enhancement or centripetal enhancement. Conclusion Osteosarcoma of the bones is diverse and occurs in vertebral bodies and long bones. It can be diagnosed if reactive osteosclerosis and MRI-enhanced centripetal enhancement occur.