【摘要】 目的探讨脊索瘤的影像特征和临床随访指标与预后的相关性分析。方法回顾性分析2009年1月—2015年12月经手术病理证实的41例脊索瘤病人的影像征象、病理分型和疾病发展等指标,其中男25例,女16例,年龄7个月～72岁,中位年龄53岁。36例行CT检查,30例行MRI检查,5例行单光子发射体层成像（SPECT）检查。采用Kaplan-Meier法计算脊索瘤术后复发率,采用Log-rank法和Cox比例风险模型对可能影响脊索瘤术后复发和转移的相关因素进行分析。结果 X线平片及CT主要表现为溶骨性骨质破坏及不规则状软组织肿块,伴特征性钙化;MRI表现以"卵石状"聚集的、T₂WI上明显高信号团块间有低信号间隔影为特征。术后1、2、4年的复发或转移率分别为33%、47%、81%。多因素分析显示病理类型、局部浸润程度是影响脊索瘤术后复发转移的独立危险因素（P<0.05）。结论影像检查有助于正确认识脊索瘤原位复发率高且易于远处转移的生物学特性,并有助于术前及预后评估。更多还原

【Abstract】 Objective To explore the correlations between the prognosis and imaging and clinical manifestations in patients with chordoma. Methods Forty-one patients of chordoma proved by operation and pathology from January 2009 to December 2015 were retrospectively analyzed. The imaging manifestations, pathological types, and clinical development after surgery were evaluated. There were 25 males and 16 females, aged from 7 months to 72 years, with a median age of 53 years.Among them, 36 cases underwent CT, 30 cases underwent MRI, 5 cases underwent SPECT. Postoperative recurrent rates were calculated using Kaplan-Meier. The Log-rank and the Cox proportional hazards model were used to analyze the factors that affect the recurrence and metastasis of operated patients. Results Chordoma mainly presented as osteolytic bone destruction and irregular soft tissue mass, with characteristic calcification or ossification on X-ray plain radiographs and CT. MRI feature on T₂WI was multiple hyperintense chunk nodules with hypointense interval gathered as "pebble ". The recurrence or metastasis rates at 1 year, 2 years, and 4 years for the whole group were 33%, 47%, and 81% respectively. Multivariate factors analysis displayed the pathological types, the degree of local infiltration, and the bone destruction were the independent risk factors influencing the recurrence and metastasis of chordoma after operation（P <0.05）. Conclusion Imaging manifestations of chordoma are useful for understanding the biological characteristics of high recurrence rate and vulnerable distant metastasis, and are helpful in preoperative evaluation and prognosis.更多还原