CAJ | 학술논문

目的：总结去分化型软骨肉瘤的影像学表现，结合文献复习提高对该病的认识和诊断水平。方法回顾性分析2003年7月～2011年9月经手术病理证实的3例去分化型软骨肉瘤的影像学资料。结果3例均行CT检查，均可见钙化；2例尚示絮状成骨样改变，其中1例表现为骨内骨化的肿块与环形钙化的软组织肿块相毗邻。所有患者均示骨皮质穿破，2例可见骨膜反应，1例可见软组织肿块。2例行MRI平扫及增强检查，T1WI呈低或等-低信号，T2WI均为高低混杂信号，其中1例示高低信号分界清晰。增强后，1例同时可见周围强化及结节状强化，另1例呈不规则强化。结论去分化型软骨肉瘤影像学上的双态表现是其典型征象，发现该征象可提示诊断。
목적：총결거분화형연골육류적영상학표현，결합문헌복습제고대해병적인식화진단수평。방법회고성분석2003년7월～2011년9월경수술병리증실적3례거분화형연골육류적영상학자료。결과3례균행CT검사，균가견개화；2례상시서상성골양개변，기중1례표현위골내골화적종괴여배형개화적연조직종괴상비린。소유환자균시골피질천파，2례가견골막반응，1례가견연조직종괴。2례행MRI평소급증강검사，T1WI정저혹등-저신호，T2WI균위고저혼잡신호，기중1례시고저신호분계청석。증강후，1례동시가견주위강화급결절상강화，령1례정불규칙강화。결론거분화형연골육류영상학상적쌍태표현시기전형정상，발현해정상가제시진단。
Objective To summarize radiological features of dedifferentiated chondrosarcoma in order to improve the diagnosis level with the aid of literature review. Methods Imaging information of 3 cases of dedif-ferentiated chondrosarcoma veriifed by pathology were retrospectively analyzed. Results The CT inspection was performed in 3 cases, and all of them demonstrated mineralization. Among them, 2 cases showed ossiifcation, and a ring and arc mineralized soft tissue mass adjacent to intraosseous ossiifed tumor was found in 1 case. Cortical bone was destroyed in 3 cases, and periosteal reaction was recognized in 2 cases with soft tissue mass showing in 1 case. The MRI inspection was performed in 2 cases, which demonstrated isointense or hypointense on T1WI, and mixed signal intensity on T2WI;there was clear demarcation between the two regions of high and reduced T2-weighted SI in 1 case, a so-called biphasic pattern. Postcontrast MR imaging demonstrated both peripheral and nodular enhancement in 1 case and heterogeneous enhancement in another case. Conclusion The radiological feature of biphasic pattern was of great importance to dedifferentiated chondrosarcoma, identifying it might have diagnostic value for this relatively rare type of chondrosarcoma.