摘要
目的探讨长骨骨端发生的骨巨细胞瘤与软骨肉瘤的影像鉴别诊断特征。方法选择我院2015年5月~2022年5月经手术病理证实为长骨骨端原发的20例骨巨细胞瘤(骨巨细胞瘤组)和16例软骨肉瘤(软骨肉瘤组)患者作为研究对象,采用独立样本t检验和Fisher确切概率法对两组患者的临床及影像学特征进行回顾性分析。结果两组影像特征比较,差异有统计学意义(P<0.05):长骨骨端骨巨细胞瘤患者发病年龄在20~40岁者占比更高(60%),单纯累及骨端(90%)、偏心性生长(70%)、边界清楚(100%)、骨皮质膨胀(95%)、均匀变薄(100%)、软组织肿块无分叶(100%)、软组织肿块局限性生长(100%)、T2WI以稍高信号为主(100%)、伴有囊变/坏死/出血/液-液平(60%)的比例更高,而长骨骨端软骨肉瘤患者发病年龄>40岁者占87.5%,病灶同时累及骨端及骨干(81.2%)、非偏心性生长(87.5%)、病灶边界不清(56.2%)、骨皮质无膨胀改变(87.5%)、皮质厚薄不均/毛糙(100%)、软组织肿块分叶状(100%)、软组织肿块包绕骨干/浸润周围组织(100%)、T2WI高信号或明显高信号(100%)、无囊变/坏死/出血/液-液平(100%)的占比更高;两组性别、有无软组织肿块、骨髓水肿、软组织渗出以及MR边缘低信号环是否完整的差异无统计学意义(P>0.05)。结论长骨骨端原发骨巨细胞瘤与软骨肉瘤在发病年龄及影像学表现中有一定相似性,通过综合评估患病年龄、发病部位、偏心与否、边界是否清晰、骨皮质有无异常改变、软组织肿块特征及MR上病变内部特点有助于二者鉴别诊断。
Objective To investigate the imaging differential diagnosis features of giant cell tumor of bone and chondrosarcoma occurring in the end of long bone.Methods Twenty patients with giant cell tumor of bone(giant cell tumor of bone group)and 16 patients with chondrosarcoma(chondrosarcoma group),which were confirmed by surgical pathology to be primary in the bone end of long bone in our hospital from May 2015 to May 2022 were selected for the study,and the clinical and imaging characteristics between the two groups were retrospectively analyzed using independent samples t-test and Fisher's precision probability test.Results Comparing the imaging features of the two groups,the differences were statistically significant(P<0.05):A higher percentage of patients with giant cell tumor of bone in the end of long bone are 20 to 40 years old(60%),and there was a higher percentage of simple involvement of bone end(90%),eccentric growth(70%),clear boundary(100%),bone cortex expansion(95%),uniform cortical thinning(100%),soft tissue masses without lobulation(100%),localized growth of soft tissue masses(100%),slightly high signal predominates on T2WI(100%),with Cystic degeneration/necrosis/bleeding/liquid-liquid level(60%).While the percentage of patients with chondrosarcoma in the end of long bone greater than 40 years was 87.5%,and there was a higher percentage of the lesions involved both the bone end and the diaphysis(81.2%),non-eccentric growth(87.5%),unclear boundary(56.2%),without bone cortex expansion(87.5%),uneven cortical thickness/roughness(100%),lobulated soft tissue mass(100%),soft tissue mass surrounding the diaphysis/infiltrating surrounding tissue(100%),high signal or Significantly high signal on T2WI(100%),without Cystic degeneration/necrosis/bleeding/liquid-liquid level(100%).There was no statistically significant difference between the two groups of gender,presence or absence of soft tissue mass,bone marrow edema,soft tissue exudation and MR edge low signal ring(P>0.05).Conclusion There are some similarities in age of onset and imaging manifestations between giant cell tumor of bone and chondrosarcoma occurring in the end of long bone.Comprehensive assessment of onset age,onset location,eccentric growth or not,clear boundary or not,abnormal changes of the bone cortex or not,features of the soft tissue mass,and internal signal characteristics of the lesion on MR can help in the differential diagnosis of the two deases.
作者
张群
刘新丽
张毅
胡明艳
李天然
ZHANG Qun;LIU Xinli;ZHANG Yi;HU Mingyan;LI Tianran(Department of Diagnostic Radiology,Fourth Medical Center,Chinese PLA General Hospital,Beijing 100048,China)
出处
《分子影像学杂志》
2023年第4期692-696,共5页
Journal of Molecular Imaging
基金
军队后勤科技成果扩试实施计划基金资助项目(军后综【2020】335号)。
关键词
长骨骨端
骨巨细胞瘤
软骨肉瘤
磁共振成像
end of long bone
giant cell tumor of bone
chondrosarcoma
magnetic resonance imaging
