软骨肉瘤的超声表现分析

Analysis of ultrasonographic features of chondrosarcoma

目的:分析软骨肉瘤的二维超声及彩色多普勒血流成像(CDFI)声像图,探讨软骨肉瘤的特征性超声表现。方法:回顾性分析经病理学确诊的19例软骨肉瘤患者的超声声像图表现,并结合其临床表现及病理分级综合分析。结果:19例软骨肉瘤,17例(89.5%)位于肌层深面,紧贴骨皮质表面;2例(10.5%)位于乳腺。肿块最长径≥5 cm者18例(94.7%),弱回声15例(78.9%),边界清晰12例(63.2%),形态不规则15例(78.9%),内部回声不均匀19例(100%),伴发骨质破坏17例(89.5%),钙化形成17例(89.5%)。CDFI血流评级0级和Ⅰ级血流12例(63.2%)。低级别软骨肉瘤9例(47.4%)、高级别软骨肉瘤10例(52.6%)。两组CDFI血流评级及钙化类型的差异有统计学意义,低级别组0级血流及斑片状钙化更多(P<0.05),但大小、边界、形态、内部回声、有无钙化、骨质破坏等方面差异无统计学意义(P>0.05)。结论:软骨肉瘤多表现为肌层深面、紧贴骨皮质生长的弱回声团块,肿块最长径多≥5 cm,边界多清晰,形态不规则,内部回声不均匀,多伴发骨质破坏、钙化形成,肿块内血供较少。低级别与高级别软骨肉瘤的超声差异主要是低级别中血供更少,钙化多为斑片状。

Objective: To analyze the imagings of two-dimensional ultrasound and color Doppler flow imaging(CDFI) of chondrosarcoma, and to investigate the ultrasonic features of chondrosarcoma. Methods: A retrospective analysis of ultrasonography was performed in 19 cases pathologically diagnosed with chondrosarcoma. Results: 17 lesions(89.5%) were located in the deep muscle and close to the bone cortex surface, and two lesions(10.5%) were located in the breast. The lesion diameters in 18 cases(94.7%) were greater than or equal to 5 cm. 15 lesions(78.9%) had weak echo. Clear boundary was shown in 12 cases(63.2%) and irregular morphology was shown in 15 cases(78.9%). Heterogeneous internal echo appeared in 19 cases(100%). 17 cases(89.5%) had bone destruction, and 17 cases(89.5%) had calcification. The blood flow grades in 12 cases(63.2%) were 0 and I. There were 9 cases with low-grade chondrosarcoma and 10 cases with high-grade chondrosarcoma. There were significant differences in blood flow grade and calcification type between low-grade chondrosarcoma and high-grade chondrosarcoma(P<0.05). However, the size, boundary, shape, internal echo, calcification, bone destruction were not significantly different(P>0.05). Conclusion: Chondrosarcoma is a kind of weak echo mass localized in the deep muscle and close to the bone cortex, with diameter greater than or equal to 5 cm, clear boundary, irregular shape, uneven internal echo. Bone destruction, calcification and less blood supply are the common ultrasonographic appearances. The most common ultrasonic difference between low-grade chondrosarcoma and high-grade chondrosarcoma is that the former has less blood supply and patchy calcification.