原发性软骨肉瘤的影像诊断

目的探讨原发性软骨肉瘤影像特点及诊断要点。方法回顾性分析13例病理证实的原发性软骨肉瘤的X线、CT、MRI表现，并与病理对照。结果13例中，常见型9例，黏液型3例，去分化型1例。发病部位：长骨7例（股骨6例，肱骨上端1例），躯干骨6例（骨盆3例，肋骨2例，胸椎1例）。X线及CT表现：呈斑片状、大片状溶骨性骨质破坏，周围骨质密度增高，骨皮质破坏、中断，局部软组织肿块。11例病灶内出现钙化。MRI表现：5例病灶T1WI呈稍低及等信号，T2WI呈显著高信号，增强后呈分隔状强化。结论X线、CT、MRI检查的综合运用，对原发性软骨肉瘤的诊断有重要的价值。

Imaging diagnosis of primary chondrosaroma

Objective To discuss the imaging characteristic and diagnostie gist of primary chondrosarcoma. Methods Conventional radiography, CT and MRI findings of 13 patients with pathologically proved primary chondrosarcoma were retrospectively analyzed and compared with pathology. Results Among 13 cases, histopathologic diagnoses were eonventional chondrnsarcoma （n =9）, myxoid chondrosarcoma（n=3） and dedifferentiated chondrosarcoma（n=1）; the tumor lesions of 7 cases were in long bone, who comprised 6 in femur and 1 in proximal humerus, while those of 6 cases were in trunk bones, who comprised 3 in pelvis, 2 in rib and l in thoraeic vertebra. Conventional radiography and CT showed that, the tumor lesions appeared as patchy-osteolytic destruction, bony marginal density increase, bony cortex erosion or interruption, and local soft tissue mass. Eleven patients associated with intralesional calcification. The tumor lesions of 5 patients who underwent MRI were slight hypointensity and isointensity on T1WI , significant hyperintensity on T2WI, and septum-form enhancement after the administration of Gd-DTPA. Conclusion The combinated application of conventional radiography, CT and MRI has important value in the diagnosis of primary chondrosareoma.