颅骨嗜酸性肉芽肿的CT和MRI诊断

CT and MRI Diagnosis of Eosinophilic Granuloma in the Skull

目的探讨颅骨嗜酸性肉芽肿的CT和MRI表现,提高对其诊断和鉴别诊断水平。资料与方法回顾性分析21例经手术病理证实的颅骨嗜酸性肉芽肿的CT和MRI表现,17例行CT平扫,12例行MR检查,10例行MR增强扫描。结果21例共发现24个病灶,其中单发19例(眼眶2例,斜坡2例,额骨9例,颞骨1例,顶骨4例,枕骨1例),多发2例。CT像上主要表现为颅骨板障的破坏,边界清楚,部分病灶内可见残留的小骨片以及大小不等的软组织肿块,密度不均匀。MR表现为T1低信号,T2高信号,CT和MRI增强扫描明显强化。结论颅骨嗜酸性肉芽肿的CT和MRI表现有一定的特征,CT和MRI有助于明确颅骨嗜酸性肉芽肿的诊断。

Objective To discuss CT and MRI features of eosinophilic granuloma in the skull, and improve its diagnostic accuracy. Materials and Methods CT and MRI data of 21 cases with eosinophilic granuloma confirmed by pathology and surgery were analyzed retrospectively. 17 cases were performed with CT plain scan, 12 cases with MR scan, including 10 cases with enhanced MR and CT scan. Results 24 lesions were found in 21 cases, there were solitary lesions in 19 cases, including 2 cases in orbit bone, 2 cases in clivus, 9 cases in frontal bone, 1 case in temporal bone, 4 cases in parietal bone, 1 case in occipital bone, and multiple lesions in 2 cases. CT features included osteolytic areas in diploe with clear margin, some residual bone within the lesion and soft tissue mass. The lesions were presented as inhomogenous density on CT, hypointensity on T1W and hyperintensity on T2W with markedly enhancement on contrast CT and MRI. Conclusion Eosinophilic granuloma have some CT and MRI characteristics, CT and MRI are helpful to the diagnosis of eosinophilic granuloma.