摘要
目的探讨骨孤立性浆细胞瘤(SBP)影像表现,以期提高影像学诊断准确率。方法收集经手术病理证实的19例SBP患者的临床和影像学资料,回顾性分析其影像学特征。结果病灶均为单发,发病部位:脊柱10例(胸椎7例,腰椎3例),扁骨3例(上颌骨1例,髂骨2例),长骨6例(肱骨3例,股骨2例,胫骨1例)。大部分病灶为膨胀性溶骨性骨质破坏,边界较清楚,骨皮质不完整,未见骨膜反应。病灶膨胀程度差异较大,内见粗大或细小骨嵴影,伴软组织肿块。MRI显示T1WI类似肌肉信号,T2WI及STIR高信号,无骨髓水肿。CT及MRI增强扫描显示明显强化。6例脊柱病灶可见“微脑征”。脊柱外病灶仅3例表现类似“微脑征”。结论“微脑征”是脊柱SBP的特征性表现,脊柱外SBP可见骨皮质扭曲呈花边状。CT及MRI表现对该病的术前诊断有一定的价值。
Objective To investigate the imaging features of the solitary bone plasmacytoma(SBP)in order to improve its diagnostic accuracy.Methods The clinical and imaging data of 19 patients who had undergone surgery with the pathological diagnosis of SBP were collected,and the SBP imaging features were evaluated restropectively.Results All the patients had single lesion in spine(n=10,including 7 cases of thoracic vertebrae,3 cases of lumbar vertebrae),in flat bones(n=3,including 1 malar process,2 ilium),in long bones(n=6,3 humerus,2 fermur,1 tibia).Most cases showed expansile osteolytic destruction with sharp border and incomplete cortex.There were varying degrees of the expansion of bone destruction,and no periosteal reaction was found.Residual crest bone of different lengthes and thicknesses in bone destruction area edge could be seen.MRI findings:the lesions showed relatively low or equal signal intensity(similar to muscle)on T 1WI and hyperintense signal on T 2WI and STIR,without bone marrow edema.All the lesions were enhanced obviously after injection of contrast medium.The manifestation of 6 spine cases were similar to the reported“mini-brain”sign,and a lace-like distortion of cortical bone were found in 3 cases of long bones and flat bones.Conclusions The"mini-brain"is characteristic appearance of SBP located in spine,and distorted cortex as lace can be observed in SBP of other bones.CT and MRI are beneficial for making the diagnosis before surgery.
作者
祝爽
宋杨
凃国建
李月洁
张伟
陈东
ZHU Shuang;SONG Yang;TU Guo-jian;LI Yue-jie;ZHANG Wei;CHEN Dong(Dept of Radiology,the Affiliated Hospital of Southwest Medical University,Luzhou,Sichuan646000,China)
出处
《临床骨科杂志》
2019年第4期454-457,共4页
Journal of Clinical Orthopaedics
基金
泸州市科学技术局科技计划项目(编号:泸市科[2013]134号)
关键词
骨孤立性浆细胞瘤
计算机断层成像
磁共振成像
solitary bone plasmacytoma
computerized tomagraphy
magnetic resonance imaging
