简体中文

论著-头颈部

不规则骨原发性动脉瘤样骨囊肿的影像评价

作者:陈利军 陈文静 杜建平

所属单位:广东省第二中医院放射科(广东 广州 510095)

PDF

摘要

目的提高对不规则骨原发性动脉瘤样骨囊肿影像学表现的认识。方法回顾性分析经手术病理证实的29例骨原发性动脉瘤样骨囊肿的影像表现。其中9例发生于不规则骨,20例发生于规则骨。结果  29例原发性动脉瘤样骨囊肿主要影像表现:1、皂泡状或吹气球样膨胀性骨质破坏:平片7例,CT  18例,MRI  19例;2、病灶内骨间隔及骨脊:平片3例, CT 7例; MRI 3例;3、病灶周围骨或纤维组织硬化:平片0例, CT 3例, MRI表现为病灶周围线状低信号影15例;4、骨壳部分断缺:  平片2例,CT  5例,  MRI  3例;5、液-           ABC的认识。液平面:  CT  2例,MRI  20例;6、骨膜反应:无;7、软组织肿块:CT 0例,MRI 1例。结论  不规则骨原发性动脉瘤样骨囊肿与常见部位ABC影像学特征大致相仿,多层螺旋CT与MRI综合分析更有助于ABC术前诊断。

Objective To improve imaging diagnosis of aneurysmal bone cyst at rare parts bone. Methods 29 cases with aneurysmal bone cyst confirmed by surgery and pathology were analyzed retrospectively. Of the 29 cases,9 cases occurred in irregular bone,5 cases of occipital,2 case of pubic, 2 case of sacrum.;20 cases occurred in regular bone, 11 case for humerus,9 case for femur. Results The major imaging signs of the 29 cases of aneurysmal bone cyst located at flat bone and irregular bone were:1、Soap bubble-like expensive bone destruction was detected by X-ray in 7 cases, by CT in 18 cases, and by MRI in 19 cases; 2、Bone trabeculae mixed with osseousseptae in the lesion were detected by X-ray in 3 cases, by CT in 7 cases, and by MRI in 3 cases; 3、Local sclerosis of the bony structure adjacent to the lesion was detected by X-ray in 0 cases, by CT in 3 cases, and by MRI in 15 cases; 4、Partial pathologic fractures of bone shells were detected by X-ray in 2 cases; by CT in 5 cases, and by MRI in 1 cases; 5、Fluid-fluid level inside the lesion was detected by CT in 2 cases, by MRI in 20 cases; 6、No periosteal reaction; 7、Soft tissue mass was detected by CT in 0 case, by MRI in 1 case. Conclusion The imaging characteristics of aneurysmal bone cyst at flat bone and irregular bone are similar to that at long-tubular bone, DSCT and MRI can distinctly improve the correct rate of diagnosis.

【关键词】骨囊肿,动脉瘤样;体层摄影术,X线计算机; 磁共振成像

【中图分类号】R445.2;R681

【文献标识码】A

【DOI】 10.3969/j.issn.1672-5131.2015.01.30

前言

动脉瘤样骨囊肿(aneurysmal bone cyst, ABC)是具有侵袭性的骨 肿瘤样病变,其病因不明,该病60%~70%发生于长管状骨干骺端,而 少见于不规则骨。本文搜集的29例原发性动脉瘤样骨囊肿经手术与病 理证实。9例为不规则骨原发性ABC,20例为常见部位原发性ABC。本文 着重分析不规则骨动脉瘤样骨囊肿多层螺旋CT及MRI表现,对比长管状 骨(常见部位)的原发性ABC的影像学征像,旨在提高对不规则骨原发性 ABC的认识。