对比分析颅底软骨肉瘤与脊索瘤CT和MRI征象

目的 对比分析颅底软骨肉瘤与脊索瘤CT和MRI征象。方法 回顾性分析经病理证实的7例颅底软骨肉瘤和18例脊索瘤患者的CT和MRI资料。结果 颅底软骨肉瘤与脊索瘤好发部位相似,以斜坡中线区多见,少数位于前、后颅窝底;其CT和MRI有共性征象：均伴颅底膨胀性或溶骨性骨质破坏,T2WI以明显高信号为主,增强后多呈"花瓣样"或"蜂房样"明显不均匀强化。5例软骨肉瘤可见明显粗大钙化,密度较高且边缘锐利,4例DWI呈低信号;16例脊索瘤无明显钙化或见细小条状残留骨嵴,仅2例DWI呈低信号。结论 颅底软骨肉瘤与脊索瘤的CT和MRI征象有一定共性,肿瘤内钙化特点及DWI信号强度对鉴别诊断有一定价值。

Comparative analysis of CT and MRI features of skull base chondrosarcoma and chordoma

Objective To comparatively analyze CT and MRI features of skull base chondrosarcoma and chordoma. Methods CT and MRI features of histopathologically proved chondrosarcoma in 7 patients and chordoma in 18 patients of the skull base were retrospectively analyzed. Results The location of chondrosarcoma was similar to that of chordoma. The tumors located at the clival region in most patients, while at the anterior and posterior cranial fossa in a few ones. Common CT and MRI features were found between chondrosarcoma and chordoma of the skull base, i.e. expansive or osteolytic destruction of the skull base, high signal intensity on T2WI, with heterogeneous enhancement showed honeycomb or petaling appearance after contrast administration. In chondrosarcoma, obvious coarse calcification with high density and sharp edge were found in 5 patients, and low signal on DWI was found in 4 patients. In chordoma, no obvious calcification but small residual bone crest strip were observed in 16 patients, whereas low signal intensity on DWI was observed in only 2 patients. Conclusion Chondrosarcoma and chordoma of the skull base have some common CT and MRI features. The features of calcification and DWI signal intensity of tumor may be valuable to differential diagnosis of skull base chondrosarcoma and chordoma.