[1]张静涛,陈凤霞,浦飞飞△.32例老年骨肉瘤临床特征与影像学表现回顾性分析[J].中国中医骨伤科杂志,2023,31(03):59-63.[doi:10.20085/j.cnki.issn1005-0205.230311]
 ZHANG Jingtao,CHEN Fengxia,PU Feifei.Clinical Features and Imaging Findings of 32 Cases of Senile Osteosarcoma: A Single Center Retrospective Study[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2023,31(03):59-63.[doi:10.20085/j.cnki.issn1005-0205.230311]
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32例老年骨肉瘤临床特征与影像学表现回顾性分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第31卷
期数:
2023年03期
页码:
59-63
栏目:
临床报道
出版日期:
2023-03-15

文章信息/Info

Title:
Clinical Features and Imaging Findings of 32 Cases of Senile Osteosarcoma: A Single Center Retrospective Study
文章编号:
1005-0205(2023)03-0059-05
作者:
张静涛1陈凤霞2浦飞飞34△
1华中科技大学同济医学院附属协和医院放射科(武汉,430022)
2武汉大学中南医院肿瘤放化疗科
3武汉市中西医结合医院(武汉市第一医院)骨科
4华中科技大学同济医学院附属协和医院骨科
Author(s):
ZHANG Jingtao1CHEN Fengxia2PU Feifei34△
1Department of Radiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;2Department of Radiation and Medical Oncology,Zhongnan Hospital,Wuhan University,Wuhan 430071,China;3Department of Orthopedic,Wuhan Hospital of Traditional Chinese and Western Medicine(Wuhan No.1 Hospital),Wuhan 430022,China;...
关键词:
老年 骨肉瘤 临床表现 影像学表现
Keywords:
senile osteosarcoma clinical manifestations imaging findings
分类号:
R738.1
DOI:
10.20085/j.cnki.issn1005-0205.230311
文献标志码:
B
摘要:
目的:分析老年骨肉瘤临床特征与影像学表现,提高对老年骨肉瘤的诊断水平,避免误诊误治。方法:回顾性分析32例经病理检查诊断证实的老年骨肉瘤患者的临床、病理及影像资料。所有患者均行X线和MRI检查,26例患者行CT检查,17例患者行SPECT-CT检查,评估软组织肿块范围、骨质破坏范围情况。结果:所有病例均为局部单发,股骨远端17例,胫骨近端6例,其他部位9例。X线检查表现为松质骨斑片状的骨质破坏,皮质边缘主要是小而密集的虫蚀样破坏。软组织肿块多表现为圆形或者半圆形,边界模糊不清,肿块内部存在瘤骨。Godman三角是骨肉瘤最常见的X线征象之一。CT检查显示病变区域都存在不规则的骨质破坏表现,内部为高密度的瘤骨影。MRI检查显示所有患者都存在不规则的骨质破坏表现,T1WI为不均匀的低信号,T2WI为高低混杂的信号,骨膜反应和瘤骨都表现为低信号。结论:老年骨肉瘤是临床少见的疾病,综合应用X线、CT、MRI和SPECT-CT检查可以提高诊断准确率。其中X线检查是老年骨肉瘤的首选检查方法,CT能够敏感识别早期骨质病变,MRI在显示肿块与周围组织的结构关系方面更具优势,SPECT-CT可以评估全身转移情况。
Abstract:
Objective:To analyze the clinical features and imaging findings of senile osteosarcoma and to improve the diagnostic level of senile osteosarcoma, and to avoid misdiagnosis and mistreatment.Methods:The clinical, pathological and imaging data of 32 patients with senile osteosarcoma confirmed by pathology were retrospectively analyzed. All patients underwent X-ray and MRI examination, 26 patients underwent CT examination, 17 patients underwent SPECT-CT examination to evaluate the extent and size of soft tissue mass and the extent of bone destruction.Results:All cases were isolated locally, including 17 distal femurs, 6 proximal tibias, and 9 other sites. X-ray showed patchy bone destruction of cancellous bone, with small but dense insect erosion predominantly at the cortical margin. The soft tissue masses were mostly circular or semi-circular with blurred boundary, and tumor bone inside the masses. Godman's triangle was one of the most common X-ray signs of osteosarcoma. CT findings showed that there were irregular bone destruction in all the lesion areas and high-density tumor bone shadow inside. MRI examination showed that all patients had irregular bone destruction, with heterogeneous low signal intensity on T1WI and mixed high and low signal intensity on T2WI. Both periosteum reaction and tumor bone showed low signal intensity.Conclusion:Osteosarcoma in the elderly is a rare disease in clinic, and the comprehensive application of X-ray, CT, MRI and SPECT-CT can improve the diagnostic accuracy. Among them, X-ray examination is the preferred screening method for osteosarcoma in the elderly, CT can sensitively identify early bone lesions, and MRI is more advantageous in showing the structural relationship between the mass and the surrounding tissues, SPECT-CT can assess the systemic metastasis.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(82274559,81904231)
中国博士后科学基金项目(2020M672369)
通信作者 E-mail:pufeifei@hust.edu.cn
更新日期/Last Update: 2023-03-10