摘要
目的:探讨骨嗜酸性肉芽肿(EG)的临床、病理及影像学表现。方法:回顾性分析经病理证实的25例骨EG患者的临床及影像学资料。结果:25例骨EG中,23例单发病灶,2例多发病灶,共27处病灶,其中发生在颅骨11例、脊椎2例、锁骨2例、肩胛骨1例、骨盆2例、长骨9例。病灶均呈圆形或类圆形溶骨性骨质破坏,无死骨及钙化;11例颅骨中10例颅骨呈穿透性骨质破坏,X线可见"双边征";2例椎体骨质破坏均不伴椎间隙破坏、狭窄;其它14例中6例伴骨膜反应、4例伴边缘硬化、3例伴膨胀性改变。病灶在CT上多呈稍高密度或略低密度肿块,MRI上多呈稍长T1、T2信号肿块,内可见坏死,周围多伴骨髓及软组织水肿,11例MRI增强扫描中2例轻度强化、4例中度强化、5例明显强化。结论:骨EG好发于儿童和青少年,其影像学表现具有一定特征性,MRI可以反映肉芽肿伴周围组织炎性水肿的病理特性,综合分析其影像学表现并结合临床可以作出准确诊断,最终确诊需行病理检查。
Objective：To study the imaging,clinical and pathology findings of eosinophilic granuloma （EG） of bone. Methods：The clinical and imaging findings of 25 patients with pathology proven eosinophilic granuloma of bone were retro- spectively analyzed. Results：Of the 25 cases with EG, there were solitary （23 patients） or multiple osteal lesions （2 pa- tients）, totally 27 lesions were found. The location of osteal lesions were skull （n= 11）, vertebrae （n= 2）, clavicle （n = 2）, scapula （n= 1）,pelvis （n= 2） and long bone （n= 9）. All lesions showed round or oval osteolytic destruction, with neitller sequestration nor calcification. Of the 10 skull lesions,penetrative osteolytic destruction manifested as ＂double line sign＂ on radiography. No intervertebral space narrowing or destruction was seen in the 2 vertebral lesions. Of the other 11 lesions, there were accompanied periosteal reaction （6 lesions）, marginal sclerosis （4 lesions）, expansively osteolytic bony destruc- tion （3 lesions）. On CT, the lesions presented as high-density or slightly low-density nodus or mass. On MRI, the lesions showed slightly low-signal on T1 WI, slightly high-signal on T2 WI,accompanied with intra-tumoral necrosis and peri-tumor- al bone marrow and soft tissue edema. Of the 11 patients had Gd-DTPA enhanced MRI, mild （n= 22）, morderate （n= 4） and marked （n= 5） enhancement could be assessed. Conclusion：EG often occurred in children and adolescents, characteristic imaging features could be seen, pathology characteristics including granuloma accompanied with peri-lesional inflammatory edema could be identified by MRI, accurate diagnosis could be obtained by comprehensive analysis of imaging in combination with clinical materials,yet the final diagnosis still depends on pathology.
出处
《放射学实践》
2013年第4期443-447,共5页
Radiologic Practice
