扁骨和不规则骨动脉瘤样骨囊肿的影像诊断

Imaging Diagnosis of Aneurysmal Bone Cyst at Flat Bone and Irregular Bone

目的:提高对扁骨和不规则骨动脉瘤样骨囊肿影像学表现的认识。方法:回顾性分析经手术病理证实的17例扁骨和不规则骨动脉瘤样骨囊肿的影像表现。17例中9例行X线检查,10例CT检查,8例MRI检查。结果:17例发生于扁骨和不规则骨的动脉瘤样骨囊肿主要表现为,①皂泡状和吹气球样膨胀性骨质破坏:平片4例,CT 8例,MRI 6例;②病灶内骨间隔及骨嵴:平片4例,CT 8例;MRI 5例;③病灶周围骨硬化:平片3例,CT6例,MRI 4例,MRI表现为病灶周围线状低信号影;④骨壳部分断缺:平片2例,CT3例,MRI 2例;⑤液-液平面:CT 5例,MRI 6例;⑥骨膜反应:无;⑦软组织肿块:CT 1例,MRI 1例。结论:扁骨和不规则骨动脉瘤样骨囊肿影像学特征与长管状骨大致相仿,螺旋CT及MRI能明显提高诊断准确率。

Objective：To improve imaging diagnosis level of aneurysmal bone cyst at flat bone and irregular bone. Methods： 17 cases with aneurysmal bone cyst confirmed by surgery and pathology were analyzed retrospectively. Of the 17 cases,9 eases underwent X-ray examination, 10 cases received CT imaging and 8 cases received MRI imaging. Results： The major imaging signs of the 17 cases of aneurysmal bone cyst located at flat bone and irregular bone were：（1）Soap bubblelike expensive bone destruction was detected by X-ray in 4 cases, by CT in 8 cases,and by MRI in 6 cases; （2）Bone trabeculae mixed wilh osseous septae in the lesion were detected by X-ray in 4 cases,by CT in 8 cases,and by MRI in 5 eases;（3）Loeal sclerosis of the bony structure adjacent to the lesion was detected by X-ray in 3 cases,by CT in 6 cases,and by MRI in 4 eases;（4）Partial pathologic fractures of bone shells were detected by X-ray in 2 eases;by CT in 3 eases,and by MRI in 2 cases; （5）Fluid-fluid level inside the lesion was detected by CT in 5 eases,by MRI in 6 eases;（6）No periosteal reaetion;（7） Soft tissue mass was detected by CT in 1 case, by MRI in 1 case. Conclusion： The imaging characteristics of aneurysmal bone cyst at flat bone and irregular bone are similar to that at long-tubular bone,CT and MRI can distinctly improve the correct rate of diagnosis.