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小儿四肢长骨嗜酸性肉芽肿的影像学诊断

Imaging diagnosis of eosinophilic granuloma in pediatric limb long bone

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【作者】 黄兆文陈久尊张小红何家维

【Author】 HUANG Zhao-wen;CHEN Jiu-zun;ZHANG Xiao-hong;HE Jia-wei;Department of Radiology,The affiliated No 2 Hospital of Wenzhou Medical College Pngyang on Campus;Department of Radiology,The Affiliated No 2 Hospital of Wenzhou Medical College;

【机构】 温州医学院附属第二医院平阳院区平阳县第二人民医院温州医学院附属第二医院放射科

【摘要】 目的探讨小儿四肢长骨嗜酸性肉芽肿(EG)的影像学表现。方法回顾性分析26例经临床病理证实的小儿长骨EG患者影像学资料,包括26例X摄片,12例CT检查,和5例MRI扫描检查。结果 26例中单发病灶17例,多发病灶9例(包括四肢长骨多发4例,累及其它骨骼5例),受累的四肢长骨包括股骨15例,肱骨9例,胫骨4例,腓骨及桡骨各1例,病灶位于骨干12例,干骺端18例,骨骺3例。X线平片15例病灶呈单发或多发囊状,部分边缘硬化,局部骨质呈膨胀性、溶骨性破坏,6例病灶呈小囊状破坏,4例骨膜层状增厚;CT扫描12例表现髓腔扩大,内见软组织肿块填充,骨皮质变薄,破坏,3例在骨松质区或骨髓腔内呈囊状破坏。MR检查均表现病灶中心T1WI多呈低或等低信号,T2WI呈高或等高混杂信号,周边多呈长T1、长T2信号,STIR病灶多呈混杂高信号。结论小儿四肢长骨EG影像学表现多样,易与肿瘤或肿瘤样病变相混淆,合适的影像学检查,并密切结合临床表现及随访观察,有助于准确诊断。

【Abstract】 Objective To investigate imaging findings of in eosinophilic granuloma(EG)pediatric limb long bone.Methods Imaging date of 26cases of pediatric EG in limb longbone confirmed by clinical pathology were retrospectively analysed,including 26cases of X-ray digital Radiography,12cases of CT examination and 5cases of MRI inspection.Results There were 17cases of single lesion and 9cases of multi-focal in all 26cases patients.The multi-lesions involved limb long bone in 4cases,involved other bones in 5caese.The limb long bone involvement included 15cases of femur,9of humerus,4of tibia,1of fibula and radius each respectively.The lesions in 12cases located in backbone,18cases in metaphysis,3cases in osteoepiphysis.In X-ray plain film,the lesions in 15cases presented single or multiple cyst,edge hardening partly,local sclerotin was swelling and dissolving destructed,lesions in 6cases presented cystic destroyed,the periosteum involved in 4cases were lamellarly thickened.In CT scan,12cases displayed that the medullary cavity expansion and soft tissue mass filling in the medullary cavity were involved,the bone cortex were thinned and destroyed,the cancellous bone area or the marrow cavity in 3cases were cystic destroyed.In all patients’ MRI examination,the lesion centre presented hypo or isointensity sign on T1WI,hyperintensity or iso-hyperintensity mixed sign on T2WI,lesions around presented hypointensity sign on T1WI and hyperintensity sign on T2WI,mixed hyperintensity sign on STIR.Conclusion The imaging manifestations of pediatric limb long bone EG were various,easily confused with tumors or tumor-like lesions.The appropriate imaging examination,combining clinical observation and follow-up closely,contributed to an accurate diagnosis.

  • 【文献出处】 医学影像学杂志 ,Journal of Medical Imaging , 编辑部邮箱 ,2014年04期
  • 【分类号】R738.1;R730.44
  • 【被引频次】6
  • 【下载频次】167
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