CAJ | 학술논문

目的探讨脊柱尤文肉瘤的临床、病理及MRI特点.方法回顾性分析9例经手术病理或穿刺活检证实的脊柱尤文肉瘤的临床、病理特征及MRI表现.结果 9例脊柱尤文肉瘤中,发生于颈椎、胸椎和腰椎各2例,骶椎3例.6例进行了MRI检查,均显示椎体骨骼信号异常,在T1WI上4例表现为中等信号,2例表现为稍低信号;在T2WI上表现为稍高信号,钆喷替酸葡甲胺(Gd-DTPA)增强后不均匀强化.3例表现为溶骨性骨质破坏、椎体压缩变扁;3例表现为椎体轻度膨胀性溶骨性破坏.相邻的椎间隙无狭窄、椎间盘信号无异常;均见周围明显的软组织肿块,增强后明显强化.HE染色并镜下观察肿瘤细胞均呈小圆形,不伴有Homer-Wright(H-W)菊形团排列;PAS染色阳性6例,NSE弱阳性2例.结论脊柱原发性尤文肉瘤的MRI表现有一定的特点,但缺乏特异性.当患者为儿童或青少年,且影像学表现为溶骨性骨质破坏伴明显的软组织肿块时需考虑尤文肉瘤的可能.
목적 탐토척주우문육류적림상、병리급MRI특점.방법 회고성분석9례경수술병리혹천자활검증실적척주우문육류적림상、병리특정급MRI표현.결과 9례척주우문육류중,발생우경추、흉추화요추각2례,저추3례.6례진행료MRI검사,균현시추체골격신호이상,재T1WI상4례표현위중등신호,2례표현위초저신호;재T2WI상표현위초고신호,구분체산포갑알(Gd-DTPA)증강후불균균강화.3례표현위용골성골질파배、추체압축변편;3례표현위추체경도팽창성용골성파배.상린적추간극무협착、추간반신호무이상;균견주위명현적연조직종괴,증강후명현강화.HE염색병경하관찰종류세포균정소원형,불반유Homer-Wright(H-W)국형단배렬;PAS염색양성6례,NSE약양성2례.결론 척주원발성우문육류적MRI표현유일정적특점,단결핍특이성.당환자위인동혹청소년,차영상학표현위용골성골질파배반명현적연조직종괴시수고필우문육류적가능.
Objective To analyze the clinical,pathological and MR imaging features of Ewing's sarcoma of vertebral column.Methods Nine cases of Ewing's sarcoma of vertebral column was proved by surgical or biopsy pathology.6 of 9 patients underwent MR imaging.Their clinical and pathological features and MR imaging manifestations were retrospectively analyzed.Results In 6 patients with MR imaging,2 tumors arose each in cervical,thoracic and lumbar vertebrae,respectively,the remaining 3 tumors in sacral vertebrae.The tumor showed isointensity in 4 cases and slight hypointensity in 2 cases on T1-weighted imaging,and heterogeneous hyperintensity signal on T2-weighted imaging and heterogeneously enhanced after contrast enhancement.Soft tissue mass were found in 6 tumors and no calcification and periosteal reaction were seen.Hematoxylin-Eosin staining demonstrated uniform small round cells in all cases and without Homer-Wright(H-W) rosettes.PAS staining were positive in 6 cases.2 cases were slightly positive for NSE.Conclusions The Ewing's sarcoma of vertebral column has some characteristic manifestations but not pathognomonic on MR imaging.The Ewing's sarcoma of vertebral column should be reminded when the patients are children or adolescent,and the lesions show obviously osteolysis of vertebral body and a concurrent large soft tissue mass.