长骨嗜酸性肉芽肿的影像分析

Imaging Analysis of Eosinophilic Granuloma of Long Bone

目的:分析长骨嗜酸性肉芽肿的影像表现,提高本病的诊断水平。方法:回顾性分析经病理证实的31例长骨嗜酸性肉芽肿的临床和影像学资料,其中X线平片31例,CT 10例,MRI 13例。结果:31例病变均为单发,发生于股骨14例,胫骨7例,肱骨6例,腓骨2例,桡骨、尺骨各1例;位于骨干23例,干骺端8例;主要表现为骨质破坏、邻近骨皮质改变、骨膜反应和软组织肿胀或肿块。术前正确诊断15例,误诊为尤文瘤7例,其它骨恶性肿瘤3例,骨髓炎、骨结核5例,骨囊肿1例。结论:长骨嗜酸性肉芽肿的影像表现有一定的特征性,细致综合的分析能提高对该病的诊断水平。

Objective：To analyze the imaging features of eosinophilic granuloma of long bone so as to improve diagnosis accuracy of the disease. Methods：The clinical and imaging materials of 31 patients with eosinophilic granuloma of long bone proved by surgery and histopathology were analyzed retrospectively. The imaging examination included X-ray films （n=31） ,CT （n=10）,and MRI （n=13）. Results：All of the 31 cases had solitary lesion,14 of them located in femur,7 in tibia,6 in humerus,2 in fibula, radius and ulna for 1 of each. 23 of the lesions involved diaphysis and 8 in metaphysis. The main imaging findings included bone destruction,adjacent bone cortex involvement,periosteal reaction and soft tissue mass or swelling. 15 cases were diagnosed accurately before surgery,but the others were misdiagnosed as Ewing＇s sarcoma in 7 cases,other malignant tumor in 3 cases, osteomyelitis or tuberculosis in 5 cases, bone cyst in 1 case. Conclusion： There are some reminding imaging features of eosinophilic granuloma of long bone, the diagnostic accuracy could be improved by careful analysis of imaging findings and clinical data.