《骨盆骨肉瘤的影像学诊断》.pdf

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1、医学影像学杂志2015年第25卷第6期JMedimagingVo1．25No．62015骨盆骨肉瘤的影像学诊断陈勇，刘杰，丁建平，张泽坤。(1．杭州师范大学附属医院放射科浙江杭州310015；2．河北医科大学第三医院放射科河北石家庄050051)【摘要】目的分析骨盆骨肉瘤的影像学表现，探讨其影像学特征和鉴别诊断。方法回顾手术病理证实的18例骨盆骨肉瘤，分析其发病情况、病理类型及影像学主要表现。结果18例病理均为普通型骨肉瘤。x线表现为混合型12例，溶骨型4例，硬化型2例，放射状骨膜反应8例，肿瘤骨及瘤样钙化14例，软组织肿块6例。C'P

2、平扫15例全部显示出软组织肿块。MRI10例均见软组织肿块，骨髓内及软组织肿块周围弥漫水肿，肿瘤骨及瘤样钙化在SWI上为低信号。发射型计算机体层摄影表现浓聚范围较病变范围广泛DSA表现为病灶部位血流丰富，大量新生肿瘤血管。结论骨盆骨肉瘤发病年龄较大，男女差别不明显，病理类型以普通型骨肉瘤为主，影像学表现以混合型骨肉瘤为主，骨膜反应以放射状为主。磁敏感加权成像有利于反映肿瘤骨和钙化。【关键词】骨肉瘤；骨盆；磁共振成像；磁敏感加权成像；体层摄影术，x线计算机；放射摄影术中图分类号：R738．1；R814．42；R445．2文献标识码：A文章

3、编号：1006—901l(2015)06-1069—04ImagingfeaturesofpelvicosteosarcomaCHENYong，LIUJie，DINGJian—ping，ZHANGZe—kun1．DepartmentofRadiology，1heA{{iliatedHospitalofHangzhouNormalUniversity，Hangzhou310015，P．R．China2．DepartmentofRadiology，TheThaHospitalAffiliatedtoHebeiMedicalUniversit

4、y，Shijiazhuang050051，P．R．ina[Abstract]0bjectiveToanalyzetheimagingmanifestationsofthepelvicosteosarcomaandtoexploreitsimagingchar—acteristicsanddifferentialdiagnosis．MethodsWeretr0spectivelyanalyzedtheclinicaldataof18casesofpelvicosteosar—comaconfirmedpathologically，inte

5、rmsofincidence，pathology，andmajorimagingfeatures．ResultsPathologically，those18caseswereallcommonosteosarcoma．X=rayshowedamixedpatternin12cases，theosteolytictypein4cases，thehardeningtypein2cases，radialperiostealreactionin8cases，bonetumorsandtumor-likecalcificationin14case

6、s，thesofttissuemassesin6cases．CTscanshowedthatall15casesexhibitedsofttissuemass．MRIshowedthat10casespres—entedwithsofttissuemassandbonemarrowandsofttissuemassweresurroundedwithdiffuseedema．Bonetumorsandtumor-likecalcificationappearedaslowsignalonSWI．Emissioncomputedtomog

7、raphyrevealedawiderrangeoftheup—takecomparedwithdiseases．DSAexaminationshowedthatthelesionsitehadrichblood，alotoffreshtumorvessels．ConclusionPelvicosteosarcomamostlyoccursintheolder．Thegendergapisnotobvious．Themajorpathologictypeisconventionalosteosarcoma．Themajorimaging

8、manifestationismixedosteosarcoma．Periostealreactionisradiallyorien—ted．Susceptibilityweightedimagingisi