骨嗜酸性肉芽肿的MRI、X线表现及病理分析

MRI,Radiography Feature and Pathology Analysis of Eosinophilic Granuloma in Bone

目的探讨骨嗜酸性肉芽肿的MRI、X线表现。资料与方法回顾分析经病理证实的骨嗜酸性肉芽肿13例患者MRI、X线资料,并结合病理分析。结果13例病灶累及颅骨4例、脊椎1例、锁骨1例、骨盆2例、长骨5例。病灶均呈圆形、类圆形溶骨性骨质破坏,无死骨,其中4例颅骨病灶呈穿透性骨质破坏,3例长骨及1例锁骨破坏区伴骨膜反应,1例长骨及1例锁骨破坏区伴边缘硬化,1例伴膨胀性改变。病灶MRI多呈稍长T1、T2信号的结节或肿块,内可见更长T1、T2信号坏死区,临近骨质多伴STIR高信号水肿区,并侵犯周围软组织,11增强后2例轻度、4例中度强化、5例明显强化。结论 EG好发于儿童和青少年,其MRI、X线影像学表现均具有一定特征性,结合临床可以作出正确诊断,最终确诊依赖病理。

Objective To explore MRI and radiography feature of bone eosinophilic granuloma. Materials and Methods 13 patients with pathologically-confirmed bone eosinophilic granuloma were retrospectively analyzed,Imaging findings, including MRI （n=13） and plain film （n=8）. Results There were 4 focuses located in skull,1 in vertebrae, 1 in clavicle, 2 in pelvis and 5 in long bone. all lesions presenting as round or oval osteolytic destruction without dead bone, 4 lesion in skull presenting as penetrativity osteolytic destruction, 3 lesions in in long bone and 1 lesions in clavicle accompanied peroisteal reaction, 1 lesions in in long bone and 1 lesions in clavicle accompanied border sclerosis,1 lesion presenting as expansively osteolytic bony destruction. On MRI, the lesion more showed lightly low-signal on T1WI, while lightly high-signal on T2WI, on STIR, around with high-signal edema and soft tissue offended,from gently to marked enhancement after Gd-DTPA injection. Conclusion EG often finded in children and teenagers, X-ray and MRI of Eosinophilic granuloma all showed characteristic imaging features,depends on the combination of clinical signs and symptoms may to make accurate diagnosis, the final diagnosis still depends on pathology.