Objective To analyze the X-ray,CT and MRI findings of chordoma in the cervical vertebrae,so as to improve its diagnostic accu-racy.Methods X-ray,CT and MRI findings of 7 cases of chordoma proved pathologically were analyzed retrospectively.X-ray and CT were undergone in all 7 cases,MRI in 3 cases.Results X-ray demonstrated bony destruction in 7 cases,bony collapse in 1 case. Narrowing of inter-vertebral space was in 6 cases and soft tissue mass was in 3 cases.CT demonstrated bony destruction in 7 cases, calcification within the tumors in 2 cases,involvement of the accessory of the cervical vertebra and transverse foramen in 5 cases. Soft tissue mass was around the cervical vertebra in 4 cases.MRI was undergone in 3 cases.On T1 WI middle signal in 3 cases were showed,on T2 WI low and high mixed signal in 3 cases,and soft tissue masses around the lesion in 3 cases.Conclusion Chordoma of the cervical vertebrae is uncommon.Full understanding X-ray,CT,MRI characteristics is useful to improve the diagnosis,guide clinical surgery treatment and forecast prognosis.

Objective To analyze the X-ray,CT and MRI findings of giant cell tumor in the thoracic vertebrae,in order to improve its diagnostic accuracy.Methods X-ray,CT and MRI findings of 9 cases of pathologically proved giant cell tumor were analyzed retrospectively. X-ray examination was performed in 7 cases,CT in 6 cases,and MRI in 7 cases.Results Of the 9 cases with thoracic vertebrae giant cell tumors,8 involved a single vertebra while 1 case involved the left ninth posterior segment of rib simultaneously.On X-rays studies, 6 cases of bone destruction were dispensability,and 1 case was osteolysis.Three cases of vertebral destructive margin were clear. The body of vertebra was flattened in 3 cases.Pore-vertebral soft tissue masses were found in 4 cases.On CT examinations,5 cases of bone destruction were dispensability,and 1 case was osteolysis.3 cases of vertebral margin were clear with partial sclerotic rim. 4 cases of vertebral body had shade of bone-cristae.There were soft tissue masses around vertebrae in 5 cases,with vertebrae accessory,dural sac and the spinal cord involved to varying degrees.On MRI studies,hypointense were showed in 5 cases while isointense in 2 cases on T1 WI;On T2 WI,isointense was showed in 1 case,hyperintense in 4 cases,and mixed-intense in 2 cases.Conclusion Giant cell tumor in the thoracic vertebrae is uncommon.Full understanding X-ray,CT,MRI characteristics is useful to improve the diagnosis, guide clinical surgical treatment and forecast prognosis.

Objective To investigate the imaging findings of Ewing’s sarcoma in ilium,pubis,and ischium,and to improve the diagnostic veracity.Methods The imaging manifestations of 1 5 patients with pathologically proved Ewing’s sarcoma in ilium,pubis or ischium were retrospectively analyzed.All the 1 5 patients were underwent X-ray examination.Among them,12 cases performed CT examination and 1 1 cases performed MRI examination.Results In all the 1 5 Ewing’s sarcoma patients,8 lesions located at the iliac.7 lesions located at the pubic and ischial.12 cases showed simple osteolytic bone destruction on X-ray images,3 cases showed mixed bone destruction.All the 1 5 cases showed soft-tissue mass around the lesion.On CT images,7 cases showed swelling in the periphery of the lesion areas and internal osteolytic bone destruction,5 cases showed irregular oateomas,hyperosteogeny or osteo-sclerosis surrounding bone destruction areas,6 cases showed irregular periosteal reactionsurrounding the lesion areas,12 cases showed soft-tissue mass surrounding the lesion areas.On MRI,7 cases showed long T1 and long T2 signal,4 caese showd T1 low and T2 heterogeneous high signal,5 cases showed high signal in the fat suppression sequences.All the 1 1 cases who underwent MRI examination showed bone destruction and soft tissue mass on MRI.Conclusion Although rare,Ewing’s sarcomas of the ilium,pu-bis,and ischium have some certain image features.X-ray,CT and MRI examinations play an important role in the diagnosis and dif-ferent diagnosis of these conditions.

[摘 要] 目的：探讨多结节非小细胞肺癌（NSCLC）组织中的驱动基因突变情况与临床病理特征的关系，为多结节NSCLC患者治疗提供分子诊断依据。方法：本研究共纳入2018年1月至2023年10月间云南省肿瘤医院分子诊断中心检测的121例多结节NSCLC患者的253个肺结节肿瘤组织标本，以第二代测序（NGS）技术或扩增阻滞突变系统PCR（ARMS-PCR）技术检测多结节NSCLC 组织中驱动基因突变情况，分析其与患者临床病理特征的关系，比较不同结节间肺癌驱动基因的突变异质性。结果：与非“宣威”NSCLC相比，“宣威”多结节NSCLC患者驱动基因突变具有显著的地域特点，表现在“宣威”患者具有较低（20%）的EGFR敏感突变（L858R、19-del）及较高（27.26%）的EGFR少见突变（主要为G719/S768I、G719）；“宣威”多结节NSCLC患者的KRAS突变率（27.27%）亦显著高于非“宣威”患者突变率（12.59%）（P<0.05）。此外，“宣威”多结节NSCLC患者驱动基因突变不一致率高达69.23%，远高于非“宣威”患者驱动基因突变不一致率（55.07%）（P<0.05）。结论：“宣威”多结节NSCLC患者具有较高的EGFR少见突变及KRAS突变率，同一患者不同病灶之间存在更高的驱动基因突变异质性，本研究将为“宣威”多结节NSCLC的诊疗策略提供更多的选择。