摘要
目的分析单骨局灶性骨纤维结构不良(FFDB)的磁共振DWI及增强影像征象及病理学基础,以提高诊断准确率。方法回顾性分析经手术病理证实或活检穿刺证实的50例FFDB的常规磁共振序列、DWI及增强特征,并结合CT平扫的表现,将MR和CT表现与病理表现进行对照。50例患者中,38例行MRI平扫,其中25例行DWI检查,13例行MR平扫及增强;50例中有38例行CT平扫。结果单骨局限性骨纤维结构不良50例,表现为骨内膨胀性骨质破坏(39/50,78%),伴不同程度磨玻璃密度(37/38,97.4%)。病灶MRI的T2WI为高或稍高信号(37/38,97.4%),合并低信号硬化边(27/38,71.1%);DWI呈高信号(23/25,92.0%),ADC均值约(1.39±0.428)×10-3mm2/s,其中磨玻璃成分T2WI为中高信号(26/26,100%),增强扫描病灶轻度及中度强化各2例(2/13,15.4%),明显强化9例(13/13,100%)。其中继发动脉瘤样骨囊肿3例(3/50)。病理特征为正常的骨组织被大量的纤维组织替代。结论FFDB具有特征性的影像学表现,MRI的T2WI序列表现为以高信号为主,伴片状低信号影,边缘见低信号环征,DWI病灶呈高信号但ADC值也高,反映了其良性肿瘤的特点;富血供强化反映了FFDB富血供的特征;再结合CT病灶合并磨玻璃密度,边缘可见骨密度硬化环-枣壳核征;传统MRI结合DWI与增强,不典型者结合CT表现,可以更全面地反映的FFDB影像学特征,提高诊断准确率。
Objective To analyze the magnetic resonance DWI and enhanced imaging signs and pathological basis of focal bone fibrous dysplasia(FFDB)in order to improve the accuracy of diagnosis.Methods Retrospective analysis of 50 cases of routine MRI sequence,DWI and enhanced features of focal bone fibrous dysplasia(FFDB)confirmed by surgical pathology or biopsy,combined with CT plain scan performance,MR and CT performance and pathological performance were performed Control.Among the 50 patients,25 were male and 25 were female;aged 7 to 63 years,with an average age of 34 years.38 cases underwent MRI plain scan,25 cases underwent DWI examination,13 cases underwent MR plain scan and enhancement;38 of 50 cases underwent CT plain scan.Results 50 cases focal fibrous dysplasia of bone showed expansive bone destruction(39/50,78%)with varying degrees of ground glass density(37/38,97.4%).High or slightly high signal intensity(37/38,97.4%)and low signal sclerosing margin(27/38,71.1%)were found in the lesions on T2WI.DWI showed high signal intensity(23/25,92.0%)and the mean ADC was about(1.39±0.428)×10-3mm2/s.Among them,the ground glass component of T2WI was moderately high signal intensity(26/26,100%),mild and moderate enhancement in 2 cases(2/13,15.4%)and obvious enhancement in 9 cases(13/13,100%).Secondary aneurysmal bone cyst(3/50).Pathological features are that normal bone tissue is replaced by a large number of fibrous tissue.Conclusion FFDB has characteristic imaging manifestations.The T2WI sequence of MRI showed high signal intensity with low signal shadows and low signal ring sign on the edge.The high DWI signal intensity and high ADC value in the lesions reflect the characteristics of benign tumors.Enhanced blood supply reflects the characteristics of FFDB blood supply.Combined with CT lesions with ground glass density,bone mineral density sclerosis ring-jujube putamen sign could be seen at the margin.Traditional MRI combined with DWI and enhancement and atypical combined CT findings can reflect FFDB imaging characteristics more comprehensively and improve diagnostic accuracy.
作者
赵娜
董江宁
高飞
史彬
陈东
曹锋
宋德梅
ZHAO Na;DONG Jiangning;GAO Fei(Department of Radiology,West Branch of the First Affiliated Hospital of Science and Technology of China(Anhui Provincial Cancer Hospital),Hefei,Anhui Province 230031,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第4期741-745,共5页
Journal of Clinical Radiology
基金
国家癌症中心,攀登基金临床研究课题2018年度立项课题(编号:NCC201812B035)
