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目的探讨骶尾部肿瘤的MR表现及鉴别诊断。方法回顾性研究39例骶尾部肿瘤患者临床资料及MRI表现。结果 39例骶尾部肿瘤中良性肿瘤共23例,包括神经鞘瘤5例、神经纤维瘤2例、神经节细胞瘤1例、蛛网膜囊肿/神经根囊肿6例、表皮样囊肿2例、皮样囊肿1例、囊性淋巴管瘤1例、纤维脂肪瘤1例、畸胎瘤2例、骨巨细胞瘤及术后复发2例。恶性肿瘤共16例,包括转移瘤9例、脊索瘤及术后复发3例、多发性骨髓瘤2例、淋巴瘤1例、滑膜肉瘤1例。鉴别诊断要点包括①肿瘤定位与椎管、骶骨、骶髂关节关系;②骨质受压与骨质破坏形态;④骨质破坏程度与软组织肿块大小比例;③肿瘤强化程度、质地均匀度;⑤有无硬化边、钙化、骨性或纤维性分隔;⑥肿块中心性或偏心性生长方式;⑦发病频率及好发年龄、性别。结论骶尾部肿瘤MRI表现综合细致分析,结合患者性别年龄及发病频率,对骶尾部肿瘤诊断及鉴别诊断有重要价值。
Objective To investigate the MR findings and differential diagnosis of sacrococcygeal tumors. Methods The clinical data and MRI findings of 39 patients with sacrococcygeal tumor were retrospectively studied. Results Twenty-three cases of benign tumors in 39 cases of sacrococcygeal tumors included 5 schwannomas, 2 neurofibroma, 1 ganglioneuroma, 6 arachnoid cysts, 2 epidermoid cysts, 1 case of cyst, 1 case of cystic lymphangioma, 1 case of fibro-lipoma, 2 cases of teratoma, 2 cases of giant cell tumor of bone and recurrence after operation. A total of 16 malignant tumors, including 9 cases of metastases, chordoma and postoperative recurrence in 3 cases, 2 cases of multiple myeloma, 1 case of lymphoma, synovial sarcoma in 1 case. The main points of differential diagnosis include ① tumor location and spinal canal, sacrum, sacroiliac joint relationship; ② bone compression and bone destruction morphology; ④ degree of bone destruction and soft tissue mass size ratio; ③ tumor enhancement, texture uniformity; ⑤ With or without sclerosis, calcification, bone or fibrous separation; ⑥ tumor central or eccentric growth pattern; ⑦ frequency and incidence of age, gender. Conclusions Comprehensive and detailed analysis of MRI findings of sacrococcygeal tumors is of great value in the diagnosis and differential diagnosis of sacrococcygeal tumors, combining with the patient’s gender, age and frequency of onset.