骨原发性非霍奇金淋巴瘤的影像学表现分析

Imaging findings of primary bone non-Hodgkin lymphoma

目的探讨骨原发性非霍奇金淋巴瘤的影像学特性,着重分析其MRI信号表现。方法回顾性分析经病理证实的21例骨原发性非霍奇金淋巴瘤的放射学和MRI表现。结果单骨发病17例,多发4例;其中病灶位于脊椎14例次,骨盆11例次,长骨5例次,颅骨1例次。放射学表现:浸润性、溶骨性骨质破坏16例,不规则硬化并浸润性骨质破坏3例,溶骨性骨破坏并囊状膨胀2例;18例见大小不等的软组织肿块影,CT扫描见软组织肿块直径平均约7.36cm,相应层面骨质破坏区直径约3.64cm。MRI检查T1WI显示病灶呈等信号12例,等低混杂信号2例;T2WI呈中等-稍高信号12例,高信号2例;增强扫描病灶明显强化者10例。结论骨盆及脊椎为本病好发部位,多侵犯单骨。骨质破坏的范围小而软组织肿块大,T2WI信号不高,增强扫描病灶明显强化,为其特征性的影像学表现,具有一定的诊断及鉴别诊断意义。

Objective To study the imaging features of primary bone non-Hodgkin lymphoma with an emphasis on MRI signal characteristics. Methods A retrospective analysis was performed to assess the radiological and MRI appearance of 21 cases confirmed to be primary bone non-Hodgkin＇s lymphomas by pathology. Results The lesions involved single bone were 17 cases, others involved multi locations; 14 cases located vertebrae, 11 cases in pelvis, 5 cases in long bone and 1 case in skull. The radiology finds were 16 cases with invasion or osteolysis osteoclasia, 3 cases with invasion osteoclasia and irregular sclerosis, 2 cases with osteolysis osteoclasia and capsular dilatation. The inequalities of size soft tissue tumors were shown in 18 cases; the average diameter of them was 7.36 cm. On MR T1WI, equal signal were 12 cases, others were equal and low signal; on T2WI equal and slight high signal were 12 cases, high signal were 2 cases. After intravenous injection of contrast agent, 10 cases were significant enhancement. Conclusion The predilection site of primary bone non-Hodgkin lymphoma is the single bone of pelvis and vertebrae, the imaging appear small invasion or osteolysis osteoclasia with large soft tissue tumor. The imaging feature of primary bone non-Hodgkin lymphoma is equal or low signal on MR T2WI and obvious enhancement, which have significance in diagnosis and differential diagnosis.