胸骨肿瘤的临床与影像学分析

发布时间：2018-05-17 05:28

本文选题：胸骨 + 骨肿瘤　；参考：《中国骨伤》2016年10期

【摘要】：目的 :分析胸骨肿瘤的临床及影像学表现。方法 :回顾性分析18例经手术或病理证实的胸骨肿瘤患者的临床及影像学资料,其中男13例,女5例;年龄24~73岁,平均58.3岁;11例保守治疗,7例手术治疗;病程2个月~6年。1例患者无明显症状,1例有胸部外伤史。18例患者经X线片、CT、MRI检查,观察骨质破坏形态、骨皮质改变、MRI信号异常、瘤周骨髓水肿以及增强强化等指标。结果 :18例中恶性骨肿瘤16例,良性肿瘤2例;发生于胸骨柄7例,胸骨体9例,胸骨柄、体部均受累2例。影像学表现上,胸骨肿瘤具有膨胀性骨质破坏的倾向,15例骨质破坏区边界连续性或部分中断,2例骨皮质边缘毛糙、变薄,1例骨皮质增厚。7例行MRI检查均未见瘤周骨髓水肿,2例可见软组织侵犯;与邻近肌肉相比,4例T1WI表现为低信号,3例呈等、高信号,6例T2WI表现为等、高信号,1例混杂信号。MRI增强扫描,大部分病例表现为明显强化。结论 :胸骨肿瘤种类多样,以恶性肿瘤居多;胸骨肿瘤的影像学表现大多缺乏特征性,结合临床表现,综合分析其X线、CT及MRI征象,有助于提高胸骨肿瘤的诊断准确性。
[Abstract]:Objective: to analyze the clinical and imaging manifestations of sternal tumors. Methods: the clinical and imaging data of 18 patients with sternum tumor confirmed by surgery or pathology were retrospectively analyzed, including 13 males and 5 females, with a mean age of 58.3 years (n = 11) and conservative treatment (n = 7). From 2 months to 6 years, 1 case had no obvious symptoms and 1 case had a history of chest trauma. 18 cases were examined by X-ray CT Mr imaging to observe the shape of bone destruction, abnormal MRI signal of bone cortical change, edema of bone marrow around tumor, enhancement and so on. Results among 18 cases, 16 cases were malignant bone tumor, 2 cases were benign tumor, 7 cases occurred in sternum stalk, 9 cases in sternum body, 2 cases in sternal stalk and body. Radiographically, the sternum tumor had the tendency of expansive bone destruction. In 15 cases, the boundary of bone destruction zone was continuous or partially interrupted. 2 cases had rough margin of bone cortex. In 1 case with thickening of bone cortex, 7 cases with thickening of bone cortex were examined with MRI, 2 cases with soft tissue invasion were found in bone marrow edema around the tumor, 4 cases with T1WI showed iso-signal intensity compared with adjacent muscles, 6 cases with high signal intensity and 6 cases with T2WI. One case with high signal intensity and mixed signal. MRI enhanced scan, most of the cases showed obvious enhancement. Conclusion: the types of sternum tumors are various, most of them are malignant tumors, and most of the imaging findings of sternum tumors are lack of characteristic. Combined with clinical manifestations, the comprehensive analysis of X-ray CT and MRI signs is helpful to improve the diagnostic accuracy of sternum tumors.
【作者单位】：平阳县中医院放射科;

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