髋臼病变的影像诊断和鉴别诊断

Imaging Diagnosis and Differentiation Diagnosis of the Diseases Involved Acetabulum

目的探讨髋臼病变的影像特点和鉴别诊断。资料与方法分析38例(以累及髋臼为主的病变)的临床资料,详细观察各种疾病的影像所见,比较不同疾病的影像差异。结果38例中良性16例,包括嗜酸细胞肉芽肿3例,骨巨细胞瘤3例,骨纤维异常增殖症2例,骨囊肿2例,软骨黏液样纤维瘤、骨韧带样纤维瘤、骨样骨瘤、软骨瘤、结核、良性未分类各1例;恶性22例,包括转移瘤12例,骨肉瘤3例,软骨肉瘤、淋巴瘤各2例,骨髓瘤、恶性纤维组织细胞瘤、恶性未分类各1例。结论几乎所有良、恶性病变均可累及髋臼,典型的病变形态与发生于其他骨骼的同种病变相一致;不典型者诊断困难,有时连良、恶性的鉴别也很困难。

Objective To discuss the imaging features of diseases involved acetabulum and its differentiation diagnosis. Materials and Methods Clinic and imaging data of 38 cases of diseases involved acetabulum were analyzed retrospectively. Results There were 38 cases of diseases involved acetabulum including 16 benign lesions（3 cases with eosinophilic granuloma; 3 cases with giant-cell tumor; 2 cases with fibrous dysplasia; 2 cases with bone cyst; cbondromixoid fibroma, desmoplastic fibroma, osteoid osteoma; chondroma and tuberculosis in each one case. In the malignant lesions, 12 cases with bone metastases; 3 cases with osteosarcoma; 2 cases with chondrosarcoma, 2 cases with non-Hodgkin lympboma; myeloma, malignant fibrohistiocytoma and unclassified malignant lesion in each one case. Conclusion All benign and malignant diseases can involve acetabulum. Typical imaging features of the disease involved acetabulum are in accordance with that in other bones. However, the diagnosis is difficult with the atypical imaging presentation, sometimes we even can not differentiate benign lesions from the malignant lesions.