CAJ | 학술논문

目的：探讨四肢长骨高级别与低级别软骨肉瘤的影像学鉴别。方法回顾分析经手术及病理证实的四肢长骨软骨肉瘤23例,其中低级别13例,高级别10例。对二者的磁共振影像学特征,包括骨皮质扇贝样改变,骨皮质增厚,骨皮质破坏,骨膨胀性改变,软组织肿块,骨髓水肿,软组织水肿,钙化,出血,肿块最大径线及增强特征分别进行统计学分析。结果低级别软骨肉瘤13例,包括非典型软骨样肿瘤及软骨肉瘤Ⅰ级；高级别软骨肉瘤10例(Ⅱ级8例,Ⅲ级1例,去分化型1例)。骨皮质破坏,软组织肿块及软组织水肿在高低级别之间差异有统计学意义,骨髓水肿有显著统计学差异。钙化+在高低级别之间有显著统计学差异,++有统计学差异。低级别软骨肉瘤肿块最大径线的直径约(6.2±2.9)cm,高级别直径约(9.3±5.2)cm,二者之间差异有统计学意义。明显斑片状/筛网状强化在高低级别软骨肉瘤之间差异有统计学意义。结论软骨肉瘤影像学特征中,骨皮质破坏、软组织肿块、软组织水肿、骨髓水肿、钙化比例、肿瘤最大径线及强化方式对鉴别四肢长骨低级别与高级别软骨肉瘤有一定价值。
목적：탐토사지장골고급별여저급별연골육류적영상학감별。방법회고분석경수술급병리증실적사지장골연골육류23례,기중저급별13례,고급별10례。대이자적자공진영상학특정,포괄골피질선패양개변,골피질증후,골피질파배,골팽창성개변,연조직종괴,골수수종,연조직수종,개화,출혈,종괴최대경선급증강특정분별진행통계학분석。결과저급별연골육류13례,포괄비전형연골양종류급연골육류Ⅰ급；고급별연골육류10례(Ⅱ급8례,Ⅲ급1례,거분화형1례)。골피질파배,연조직종괴급연조직수종재고저급별지간차이유통계학의의,골수수종유현저통계학차이。개화+재고저급별지간유현저통계학차이,++유통계학차이。저급별연골육류종괴최대경선적직경약(6.2±2.9)cm,고급별직경약(9.3±5.2)cm,이자지간차이유통계학의의。명현반편상/사망상강화재고저급별연골육류지간차이유통계학의의。결론연골육류영상학특정중,골피질파배、연조직종괴、연조직수종、골수수종、개화비례、종류최대경선급강화방식대감별사지장골저급별여고급별연골육류유일정개치。
Objective To investigate the imaging differentiation between high-grade and low-grade limb of long bone chon-drosarcoma.Methods The MRI imaging features in 23 cases of pathologically proven limb long bone chondrosarcomas were retro-spectively analyzed,including 13 cases of low-grade and 10 cases of high-grade.The MRI imaging features including endosteal scal-loping lesion,cortical thickening,cortical destruction,bone expansion,soft tissue mass,bone marrow edema,soft tissue edema,calci-fication,hemorrhage,tumour maximal radial line and enhancing features were performed the statistical analysis.Results 13 cases were the low-grade chondrosarcomas,including atypical cartilaginous tumour and grade 1 chondrosarcomas,10 cases were high-grade chondrosarcomas (8 cases of grade Ⅱ chondrosarcomas,1 case of gradeⅢ chondrosarcomas and 1 case of dedifferentiated chondrosarcomas).Cortical destruction,soft tissue mass and soft tissue oedema had statistical differences between the low-grade and high-grade.Bone marrow had statistically significant difference.Calcification +(SC<1/3ST)had statistical difference between the low-grade and the high-grade.Calcification ++(1/3 ST<SC<2/3ST)had statistical difference.The diameter of maximal ra-dial line in the low-grade chondrosarcomas was (6.2 ±2.9)cm and which in the high-grade was (9.3±5.2)cm,showing statisti-cal difference between them.The speckling and sieving enhancement had statistical differences between the low-grade and high-grade chondrosarcomas.Conclusion In the MRI imaging features of chondrosarcoma,cortical destruction,soft tissue mass,bone marrow edema,soft tissue edema,bone marrow edema,calcification proportion,tumor maximal radial line and enhancing features can be valuable to differentiate low-grade from high-grade limb long bone chondrosarcoma.