骨肿瘤影像表现1.ppt

脊柱肿瘤的影像学诊断;脊柱肿瘤的影像学诊断;脊 柱;颈段：7个颈椎 胸段：12个胸椎 腰段：5个腰椎 骶段：5个骶椎 尾段：4个尾骨 椎间盘、椎间关节、椎旁韧带等 ;椎骨:椎体、椎弓和7个骨性突起组成 椎弓:椎板、椎弓根，相邻椎弓根间构成椎间孔 椎管:各椎骨的椎孔共同连成 颈椎 环椎:前后弓及两侧块 枢椎:齿状突、椎体及棘突 第3至第7椎体：逐渐增大，椎孔三角形，椎间关节面近呈水平位，钩椎关节（Luscka 关节） 胸椎：逐渐增大，椎孔心形，关节突关节面呈冠状位 腰椎：椎体逐渐增大，椎孔呈三角形，关节突关节面呈矢状位 骶骨：骶骨倒立扁三角形，5个骶椎融合而成 尾骨: 4个尾椎融合而成 ; 骨间连接;C1-2;C3-7;T;L;S;;;检 查 技 术 ;检查技术;影 像 解 剖 ;常 规 X 线 ;T;L;L- oblique ;CT解剖;L;MRI解剖; 脊柱良性肿瘤和肿瘤样病变 ;脊柱良性肿瘤和肿瘤样病变;骨血管瘤;最常见的脊柱原发良性肿瘤 低血压慢血流血管组成，掺杂于骨小梁和脂肪间，易出血 病理上分毛细血管型和海绵状血管型 多胸椎椎体,多单椎体病变 任何年龄均可发生，一般无症状，多女性 对放射线有相当的敏感性 ;骨血管瘤 影像表现;骨血管瘤 影像表现;Plain film;T;Fig. A thickened trabeculae (corduroy sign) of a vertebral body hemangioma can be seen on this lateral view, which is coned down to the L2 vertebral body Fig. B T1WI and Fig. C T2WI show the typical increased signal intensity of a vertebral body ;骨软骨瘤; 临床病理;骨软骨瘤 影像表现;骨软骨瘤 影像表现;38, yr, M of C;Sagittal T1-weighted FigDand T2* gradient-echo FigEMR images reveal the signal intensity characteristic of yellow marrow within the osteochondroma and the impression of the tumor on the spinal canal (arrows), although the marrow and cortical continuity is not well seen. ;FigF: Photograph of the gross specimen shows the marrow and cortex of the osteochondroma and a small cartilage cap at its periphery (arrowheads). ;35yr，F Osteochondroma of sacrum malignant transformation;FigCAxial CT scan shows the thick cartilage cap (arrows) and sacroiliac joint invasion, which represents malignant transformation.;multiple hereditary exostoses. Note that the large sacral lesion has normal cortex as well as marrow arising from the underlying bone. This appearance defines an exostosis. We look for a thick cartilage cap to suggest degeneration of an exostosis to a chondrosarcoma. In this case, there is no space for a thick cap because the edge of the exostosis extends to the subcutaneous tissue. If there is any question, MR imaging can demonstrate the cartilage thickness. In this case, we recognized multiple exostoses because of the p