骶骨原发恶性肿瘤临床少见,种类繁多;脊索瘤、软骨肉瘤、骨髓瘤、淋巴瘤、尤文肉瘤相对较常见,都有骨质破坏、软组织肿块的共同特点,鉴别诊断困难。本文结合文献对这些肿瘤的X线平片、CT和MRI影像学特点进行综述,并探讨最新影像技术在其诊断、预后评估的价值,以提高对骶骨常见原发恶性肿瘤的影像学认识水平。 Primary sacral malignancies are rare and have a wide range of clinical features. Chordomas, chondrosarcomas, myelomas, lymphomas, and Ewing’s sarcomas are relatively common and have common features of bone destruction and soft tissue mass, making differential diagnosis difficult. This review summarizes the radiographic, CT and MRI features of these tumors in combination with the literature and explores the value of the latest imaging techniques in their diagnosis and prognostic assessment to improve the imaging knowledge of common primary malignant tumors of the sacrum.