【摘要】 目的:探讨骶骨和骶骨旁原发肿瘤影像学特点。材料与方法:回顾性分析了22例经手术病理证实的骶骨和骶骨旁的原发肿瘤,其中巨细胞瘤7例,神经鞘瘤4例,滑膜肉瘤5例,脊索瘤4例,软骨肉瘤及腹膜后丛状神经纤维瘤各1例。结果:（1）巨细胞瘤好发于年轻成人,常累及骶_1～3,呈多房性膨胀骨质破坏;（2）神经鞘瘤表现为骶前正中圆形且轮廓锐利的肿块,瘤内有坏死囊变,部分囊内见液平,相应骶孔扩大;（3）骶骨旁滑膜肉瘤常呈分叶状肿块,于骶_3～5水平偏于骶骨一侧,有邻近骨质和肌群浸润;（4）骶骨脊索瘤常为骶_3～5中央性肿块,瘤内有不规则残余骨嵴或/和钙化;（5）瘤内大片钙化的软骨肉瘤和沿神经丛对称葡萄状分布的腹膜后丛状神经纤维瘤在影像上也各有特点。结论:骶骨和骶骨旁原发肿瘤的临床及影像学特点将有助于诊断和鉴别诊断。更多还原

【Abstract】 Objective:To explore the imaging features of sacral and parasacral primary tumors.Materials and Methods:Twenty- two pathologically proved cases,including giant cell tumor(n=7),neurilemmomas(n=4),parasacral synovial sarcomas(n=5), sacral chordoma(n=4),chondrosarcoma and retroperitoneal plexiform neurofibroma(n=2),were studied retrospectively. Resuns:(1)Sacral giant cell tumors affect commonly in young adults and involve predominately sacrum 1～3 with a multilocular and expansile destrutive area;(2)Neurilemmomas present as a presacral mass with some enlarging sacral proes.Necrosis and for- mation of cysts happened to the masses.Some cysts with fluid level can be seen;(3)Parasacral synovial sarcomas usually appear as an undulant neoplasm beside sacrum 3～5 and infiltrate contiguous bone and musele;(4)Sacral chordoma present as a midline destructive lesion,involving prominently at sacrum 3～5,with flocculent calcification and irregular bone crests;(5)Chondrosarco- ma with a massive amorphous calcification and retroperitoneal plexiform neurofibroma with a cluster of hypotensive masses dis- tributing symmetrically as a bunch of grapes along nervous plexus can be meet incidentally.Conclusion:Imaging and clinical fea- tures of sacral and parasacral primary tumors would be helpful to diagnosis and differentiate diagnosis.更多还原