颅骨动脉瘤样骨囊肿的影像学表现

Imaging Findings of Aneurysmal Bone Cyst in the Skull

目的 探讨颅骨动脉瘤样骨囊肿的影像学表现 ,提高对颅骨动脉瘤样骨囊肿的认识。资料与方法 搜集经手术病理证实的 4例颅骨动脉瘤样骨囊肿 ,全部病例均作了CT平扫与MRI检查 ,其中 1例摄有颅骨平片 ,1例MRI增强扫描 ,1例DSA检查。结果 4例颅骨动脉瘤样骨囊肿中 ,1例位于左蝶骨嵴和左眶骨处 ,2例位于左颞骨 ,1例位于右额骨。CT上均表现为不同程度的膨胀性吹气球样溶骨破坏区 ,密度不均匀 ;MRI示有出血、囊变及液面 ,T1WI和T2 WI上呈混杂信号 ,1例增强后示肿瘤实质和邻近脑膜强化 ;血管造影示血管有推移改变。结论 颅骨动脉瘤样骨囊肿的影像学表现有一定的特征性 ,CT与MRI相结合能提示诊断 ,并有助于评价周围结构。

Objective To discuss the imaging features of aneurysmal bone cyst in the skull.Materials and Methods Imaging findings in 4 patients with pathologically proved aneurysmal bone cyst were reviewed. Imaging materials included plain CT (n=4), MRI (n=4), radiography of the skull (n=1), enhanced MRI (n=1) and DSA (n=1).Results Of 4 cases, the lesions were located at left sphenoidal crest and orbit in 1, at left temporal bone in 2 and at right frontal bone in one. On plain CT scans, the lesions presented as expanding, osteolytic destruction with inhomogeneous density. On MRI, hemorrhage, cystic degeneration and fluid level were seen, which showed mixed signal intensity on T 1WI and T 2WI. On enhanced scans, the solid part of the tumor as well as the neighboring meninges showed enhancement. Vascular displacement due to space-occupying effect of the lesion was seen on DSA.Conclusion The aneurysmal bone cyst in the skull carries certain imaging characteristics. A combination of CT with MRI is of help for suggesting the diagnosis and evaluating the neighboring structures.