动脉瘤样骨囊肿的影像和病理学表现

The pathological and imaging features of aneuriysmal bone cyst

目的:分析动脉瘤样骨囊肿(aneuriysmal bone cyst,ABC)的影像学及病理学特点,以期提高ABC的诊断水平。方法:回顾性分析32例经病理证实的动脉瘤样骨囊肿的影像学表现,全部病例中行X线检查20例,行CT检查17例,行MRI检查14例,部分患者在X线检查后进行了CT或MRI检查。结果:病灶分布于四肢长骨18例,脊椎8例、骨盆4例、下颌骨1例、跟骨1例;在X线和CT表现为上ABC表现为偏心性和膨胀性骨质破坏,MRI表现为多囊性病灶,T1WI呈低信号,T2WI呈高信号;病理均表现为含血囊腔及结缔组织性的间隔。结论:动脉瘤样骨囊肿有其特征性影像学表现,普通X线检查是最基本的首选检查方法,CT和MRI在显示动脉瘤样骨囊肿病灶内部结构和鉴别诊断上具有优势,综合影像学检查能提高动脉瘤样骨囊肿诊断符合率。

Objective：To analysis the pathological and imaging features of aneuriysmal bone cyst（ABC）,and improve the diagnostic level in this disease.Methods：32 cases of imaging data with pathologically proved ABC were retrospectively analyzed,imaging materials included ordinary X-ray photographs（n=20）,CT scans（n=17）and MRI（n=14）,some cases were examined by both scan of CT or MRI after X-ray examination.Results：Of all cases,the lesion was locate at long bones in 18,and at vertebra in 8,at pelvic in 4,each cases at mandible and the calcaneus.On plain film and CT images,the lesion was characterized by eccentric and expanding bony destruction,MR images showed a polycystic appearance with low intensity in T1WI and high intensity in T2WI,all the lesions were composed of blood filled spaces and separated by connective septa in pathology.Conclusion：Aneurysmal bone cyst have some identical characteristics,ordinary X-ray examination was the most basic method of examination for aneuriysmal bone cyst,CT an MRI scans superior to the plain radiography in showing the inner structures and differential diagnosis,it contributes to diagnosing ABC combining with plain film,CT and MRI.