骨外黏液样软骨肉瘤CT、MR特征及病理基础

发布时间：2018-04-13 13:38

本文选题：黏液样软骨肉瘤 + 软组织肉瘤　；参考：《临床放射学杂志》2015年09期

【摘要】：目的分析骨外黏液样软骨肉瘤(EMC)的CT、MR特征及病理基础,以提高对该病的影像诊断水平。方法回顾分析6例经手术病理证实的EMC患者的影像、病理及临床资料。所有患者均行CT平扫,其中2例行增强扫描,5例行MRI平扫及增强扫描。分析肿瘤的部位、形态、大小、包膜、密度/信号以及强化方式与病理学表现之间的关系。结果 6例EMC位于臀部2例,腹股沟、盆腔、小腿、前胸壁各1例。肿块最大径1.9~14.4 cm,其中圆形或椭圆形2例、不规则分叶状4例。影像学上边界清楚2例,相应病理学显示完整包膜;边界不清楚4例,相应病理学显示病灶突破包膜。影像学上6例均未见明显钙化,其中病灶密度均匀1例,密度/信号不均匀5例,增强后病灶边缘、内部分隔及实性部分呈明显强化,无强化区域病理学显示为肿瘤组织内出血、局灶性坏死。结论EMC影像学表现有一定特征,多表现为密度/信号不均、无钙化的较大分叶状软组织肿块,增强后病灶边缘、内部分隔及实性部分呈明显强化。其CT、MRI影像学特征与病理学表现关系密切。
[Abstract]:Objective to analyze the CT Mr features and pathological basis of extraosseous myxoid chondrosarcoma (EMC) in order to improve the imaging diagnosis of the disease.Methods the imaging, pathological and clinical data of 6 patients with EMC confirmed by operation and pathology were retrospectively analyzed.All patients underwent plain CT scan, of which 2 cases underwent enhanced scan and 5 cases underwent MRI plain scan and enhanced scan.The relationship between tumor location, morphology, size, capsule, density / signal, and enhancement was analyzed.Results 6 cases of EMC were located in buttocks in 2 cases, inguinal in 2 cases, pelvic cavity in 1 case, calf in 1 case, anterior chest wall in 1 case.The maximum diameter of the tumor was 1.9 ~ 14.4 cm, of which 2 cases were round or ellipse, 4 cases were irregular lobulation.The boundary was clear in 2 cases, the corresponding pathology showed the complete capsule in 2 cases, and the boundary was not clear in 4 cases, the corresponding pathology showed that the lesion broke through the capsule.No calcification was found in all of the 6 cases, including 1 case with homogeneous density and 5 cases with uneven density / signal intensity. The margin of the lesion was enhanced after contrast enhancement, and the internal septum and solid part were obviously enhanced.No-enhanced regional pathology showed hemorrhage and focal necrosis in tumor tissue.Conclusion the imaging findings of EMC are characterized by uneven density / signal intensity, large lobular soft tissue mass without calcification. The margin of the lesion is enhanced after enhancement, and the internal septum and solid part are obviously enhanced.The imaging features of CTU MRI were closely related to the pathological findings.
【作者单位】：浙江大学医学院附属第二医院放射科;浙江大学医学院附属第二医院病理科;
【分类号】：R738;R730.44;R445.2

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