儿童肩胛骨骨质破坏性病变的X线与CT分析

X-ray and CT diagnosis for skeletal destructive lesions of scapula in children

目的探讨儿童肩胛骨骨质破坏性疾病的X线、CT诊断及鉴别。方法收集我院经病理诊断的儿童肩胛骨骨质破坏性疾病患者3例及文献中的患者5例,回顾性分析X线、CT征象。结果尤文氏肉瘤3例、毛细血管瘤3例、嗜酸细胞肉芽肿2例。尤文氏肉瘤:骨破坏及骨膜增生伴行,放射状、针状骨膜反应具有特征性;毛细血管瘤:皮质常增厚,骨质破坏呈筛孔状,边缘明显硬化,无骨膜反应,常伴周围软组织血管瘤;嗜酸细胞肉芽肿:骨质破坏的边缘明显硬化,"钮扣"样死骨具有特征性。结论儿童肩胛骨骨质破坏性病变良性多见,各疾病X线、CT征象有特征性,认识其影像学特征,有助于疾病的诊断与鉴别。

Objective To analyze the X-ray and CT findings for skeletal destructive lesions of scapula in children.Methods Eight patients with skeletal destructive lesions of scapula were reviewed retrospectively with X-ray and CT,3 patients verified by histopathology and 5 patients in papers.Results There were 3 cases of Ewing＇s sarcoma（ES）,3 cases of capillary hemangioma and 2 cases of eosinophilic granuloma.It was found that skeletal destruction and periosteal reaction that the festure was radial and acicular in ES Patients;the skeletal destructive lesions of capillary hemangioma appeared honeycomb-like,the border was hardening,and the soft tissue hemangioma was often found near the lesions.The border of skeletal destructive lesions in eosinophilic granuloma was apparent osteosclerosis,and the button-like sequestrum had evident feature.Conclusion Most of skeletal destructive lesions of scapula in children are benign.X-ray and CT findings of these tumors have the certain characteristic findings.CT combined with X-ray film is helpful in diagnosis and differential diagnosis of skeletal destructive lesions of scapula in children.