[骨与软组织肿瘤的磁共振成像与组织学对比研究]。

Nihon Seikeigeka Gakkai zasshi Pub Date : 1995-10-01
K Itoh
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引用次数: 0

摘要

近年来,随着磁共振成像(MRI)的发展,骨和软组织肿瘤的诊断方法取得了很大的进步。在这里,我们报告比较评估骨和软组织肿瘤的组织学发现与MRI从212例。定性诊断的准确性见于单纯性骨囊肿、内生纤维瘤、巨细胞瘤、软骨肉瘤、脂肪瘤、血管瘤、神经瘤和滑膜囊肿。然而,由于肿瘤内组织学变化的多样性,恶性肿瘤的定性诊断是困难的。使用Gd-DTPA的增强图像有助于区分肿瘤内部的活区,水肿的接收区或评估血管性,以及区分囊肿和实体瘤。通过与切除标本的对比,发现MR图像准确反映了钙化、纤维化、出血、坏死等组织学变化,以及有无肿瘤包膜。然而,肿瘤向骨皮质和关节软骨的浸润在MRI上经常被发现为假阳性。尽管在评估肿瘤是否浸润邻近组织、骨膜反应的描述、与炎性疾病的鉴别等方面仍有待解决,但MRI可以评估肿瘤与邻近血管或神经的关系、术前治疗的效果、有效区分肿瘤的良恶性,是手术规划的一个非常有用的信息源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[A comparative study between magnetic resonance imaging and histological findings of bone and soft tissue tumors].

Diagnostic methodology for bone and soft tissue tumors has made great strides recently through the development of magnetic resonance imaging (MRI). Here we report a comparative assessment of the histological findings of bone and soft tissue tumors with MRI from 212 cases. The accuracy of a qualitative diagnosis was observed in a solitary bone cyst, enchondroma, giant cell tumor, chondrosarcoma, lipoma, hemangioma, neurinoma, and in a synovial cyst. However, the qualitative diagnosis of a malignant tumor was difficult because of the variety of the intratumoral histological changes. An enhanced-image using Gd-DTPA was useful for differentiation of the viable region in the internal area of a tumor, discrimination of the rective zone of an edema or assessing vascularity, and for discrimination between a cyst and a solid tumor. Based on comparison with findings from the excised specimen, it was found that histological changes such as calcification, fibrosis, hemorrhaging and necrosis, and the presence or absence of a tumor capsule had been reflected accurately on MR images. However, infiltration of the tumor into the bone cortex and into the articular cartilage were found frequently to be false-positive on MRI. Although problems remained to be solved regarding the evaluation of the presence or absence of tumor infiltration into adjacent tissue, the depiction of periosteal reaction, and regarding differentiation from inflammatory disease, MRI was a very useful information source for operative planning because it could evaluate the relationship between the tumor and adjacent blood vessels or nerves, the effect of preoperative therapy, and effectively discriminate between benign and malignant tumors.

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