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1、骨肉瘤的X线、CT和MRI诊断分析作者：梁丽宁成官迅黎蕾张刚刘婷【摘耍】目的探讨骨肉瘤的X线、CT和MRI诊断价值，提高对原发性骨肉瘤的影像学认识。方法回顾53例经病理证实的原发性骨肉瘤的X线、CT或MRI检查资料。结果53例中经X线检查49例，正确率为89.8%;CT检查10例,正确率为90%;MRT检查32例，正确率为96.9%o骨肉瘤基本影像表现为骨质破坏、骨膜反应、瘤骨和软组织肿块。49例X线表现为成骨型19例，溶骨型13例，混合型17例;X线对骨质破坏、骨膜反应、软组织肿块、瘤骨和Codman三
2、角的检出率分别为61.2%、95.9%、71.4%、73.5%和27.7%;10例CT表现均可见骨质破坏、软组织肿块及瘤骨，CT对骨膜反应、筛孔征和Codman三角的检出率为90%、90%和11%;CT对显示细小肿瘤骨和筛孔征最敏感，但对Codman三角的显示不如X线平片;32例MRI表现为骨髓腔内正常的骨髓高信号被肿瘤信号所取代，T1WI呈低〜等信号，T2WI呈混杂信号，7例合并出血，24例屮央坏死囊变，32例增强扫描均呈不均匀强化及瘤周可见水肿区。结论X线价廉物美，空间分辨力高，是骨肉瘤的首选检查方法
3、，CT、MRI作为X线的补充，可以提供更丰富的诊断信息，对患者治疗方式的决策必须经MRI检查。X线、CT和MRI三者结合，可提高骨肉瘤影像诊断的准确性。【关键词】骨肉瘤放射摄影术体层摄影术X线计算机磁共振成像[Abstract]ObjectiveToapproachthevalueofX-Ray,CTandMRIinthediagnosisofosteosarcomaandtoimprovetheunderstanding1evelofprimaryosteosarcoma・MethodsTmagingo
4、fX-Ray,CTand/orMRIin53patientswithprimaryosteosarcomaprovedbypathologywerereviewed.Results49patientswereexaminedbyradiographyandtheexactratewas89.8%;10patientswereexaminedwithCTscanandtheexactratewas90%;32patientswereexaminedwithMRTscanandtheexactratewas9
5、6.6%rate・Thefundamentalimagingfeaturesofosteosarcomawereshowedbonedestruction,periostealreaction,neoplasticboneandsoft-tissuemass・Among49casesexaminedbyradiography,osteoblasticpatternsarcomawasfoundin19cases,osteolyticpatternsarcomawasfoundin13casesandmix
6、edpatternsarcomawasfoundin17cases・Thedetectionratesofbonedestruction,periostealreaction,soft-tissuemass,neoplasticboneandCodmantrianglebyradiographywererespectively61.2%,95.9%,71.4%,73.5%and27.7%.All10caseswithCTscanwereshowedbonedestruction,soft-tissuema
7、ssandneoplasticbone・Thedetectionratesofperiostealreaction,憩ievesign揭andCodmantrianglewithCTscanwererespectively90%,90%and11%.Thetinyneoplasticboneand^sievesign?,wereshowedsensitivelybyCT,butCodmantrianglewasshowedbyradiographysuperiortoCT.32caseswithMRIsc
8、anpresentedthenormalmarrowwasreplacedbythetumor,whichwasshowedlowtointermediatesignalintensityonTl~weightedimagesandpromiscuitysignalintensityonT2-weightedimages・7casespresentedhemorrhageand24casespresentednecrosis・
