继发性软骨肉瘤的影像学诊断

Image Manifestation on Subsequent Chondrosarcoma

目的 探讨继发性软骨肉瘤的影像学表现。方法 回顾性分析 4例经手术证实的继发性软骨肉瘤的X线平片及CT表现。结果 恶变发生在骨盆 3例 ,股骨 1例。X线平片表现为软骨帽不规则增厚、破坏或消失 ,钙化成堆 ,密度不均 ;基底部及骨干骨皮质溶骨性破坏 ,骨膜出现放射状骨针及Codman三角 ;软组织明显肿胀。CT表现为软骨帽钙化增多 ,骨质破坏 ;基底部及骨干皮质虫蚀样破坏 ;瘤内广泛的不规则钙化或环状化及骨化影 ,密度不均 ;放射状骨针及骨膜三角 ;软组织明显肿胀。结论 继发性软骨肉瘤的影像学表现具有特征性。常规X线及CT检查是诊断本病的可靠方法 。

Objective To explore the image manifestation on subsequent chondrosarcoma. Methods A retrospective analysis was done in 4 patients with subsequent chondrosarcoma proved by operative histology. Rerults Canceration of 3 cases occurred in the pelvis,1 case in the femur.X ray showed irregular incrassation,destruction or disappearance of cartilaginous cap with calcification under heterogeneous density,the osteolytic destruction of the bone cortex of basal part and Codman triangle in the periosteum,and obvious tumefaction of soft tissues.CT scanning mainly showed the following: calcification increase of cartilaginous cap and destruction of bone substance,vermiform destruction of bone substance in the bone cortex of basal and diaphysis, irregular calcification or annular calcification and ossification image with heterogeneous density in the tumor, radioactive bone spicule and Codman triangle, and obvious tumefaction of soft tisssues. Conclusion The image manifestation is characteristic on subsequent chondrosarcoma.X ray and CT scanning are reliable ways for diagnosing the disease.