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目的 探讨骨外周性原始神经外胚层瘤 (pPNETs)的临床和影像学表现。方法 分析 10例骨pPNETs的临床和X线、CT及MR影像资料。结果 pPNETs多以局部疼痛 (9例 )伴肿块 (7例 )为主诉。X线示溶骨性骨质破坏 8例 ,伴有不规则硬化和轻度膨胀的溶骨性骨质破坏 1例 ,未见异常 1例 ;7例见软组织肿块 ;均未见骨膜反应。 7例CT扫描中 ,边界不清的溶骨性骨质破坏 6例 ,伴有不规则硬化和轻度膨胀的溶骨性骨质破坏 1例 ,均有软组织肿块形成 ,2例伴有细小的点状钙化 ,均未见骨膜反应 ;10例MR扫描中 ,9例在T1WI呈等信号 ,1例呈中等偏高信号 ;在T2 WI和短时反转恢复(STIR)序列 ,8例呈不均匀中、高信号 ,2例呈均匀高信号 ;均见明显软组织肿块形成 ;4个疗程化疗以后 ,肿瘤有明显缩小。结论 骨pPNETs以溶骨性骨质破坏伴明显的软组织肿块、无骨膜反应为主要表现 ,缺乏特征性 ,但影像学检查有助于了解病变的范围、治疗措施的制定和治疗效果的评价。
Objective To investigate the clinical and imaging features of peripheral primed neuroectodermal tumors (pPNETs). Methods Clinical and X-ray, CT and MR imaging data of 10 cases of bone pPNETs were analyzed. Results Most of the pPNETs were mainly localized pain (n = 9) with mass (n = 7). X-ray showed osteolytic bone destruction in 8 cases, with irregular hardening and mild swelling of osteolytic bone destruction in 1 case, no abnormalities in 1 case; 7 cases of soft tissue mass; no periosteal reaction. In 7 cases of CT scan, 6 cases of unclear osteolytic bone destruction, 1 case of osteolytic osteoclasts with irregular sclerosis and slight swelling, soft tissue mass formation, 2 cases with small There was no periosteal reaction in punctate calcification. Of the 10 MR scans, 9 showed equal signal at T1WI and 1 showed moderate signal. In T2 WI and STIR sequences, 8 showed no signs Even moderate and high signals, 2 cases showed a uniform high signal; were seen soft tissue mass formation; 4 courses of chemotherapy, the tumor was significantly reduced. Conclusion Bone pPNETs are characterized by osteolytic osteoclasts with obvious soft tissue mass and no periosteal reaction. They lack the characteristic features. However, imaging examination can help to understand the extent of the lesion, the development of therapeutic measures and the evaluation of the therapeutic effect.