骨嗜酸性肉芽肿与骨髓炎、尤文肉瘤的影像学比较

Imageology analysis and comparision of bone eosinophilic granuloma,osteomyelitis and Ewing's sarcoma

目的通过比较与嗜酸性肉芽肿容易误诊的骨髓炎、尤文肉瘤影像表现,以提高各病的影像学诊断与鉴别诊断。方法回顾分析病理或随访观察明确的83例患者的X线、CT、MRI影像表现。三者平均高发年龄2～25岁。长管状骨骨干或干骺端发病最多各19例。结果 1例ECG误诊为Ewing,1例Brodie误诊为ECG,1例急性骨髓炎误诊为ECG,3例Ewing误诊为骨髓炎。主要影像学表现为骨质破坏或硬化、邻近骨皮质改变、骨膜反应或骨化、骨髓水肿、软组织肿胀和肿块,多有相似表现,差异性改变也明显。结论综合分析比较三者影像表现的不同特征,对它们的诊断和鉴别诊断有较大帮助。

Objective To compare the imageology characteristics of eosinophilic granuloma, osteomyelitis and Ewing＇s sarcoma,so as to improve diagnostic accuracy of these diseases. Methods A retrospective analysis was carried out on X-ray,CT and MRI imaging manifestations of 83 patients （confirmed＇pathologically or clinically）.These three kinds of diseases are common in an age range of 2-25 years.19 cases of long bone （diaphyseal or metaphyseal）in each kind of diease. Results In 1 case ECG was mistaken for Ewing＇s sarcoma,1 case Brodie＇s abscess for ECG,1 case acute osteomyelitis for ECG, 3 cases Ewing＇s sarcoma for osteomyelitis. The main imaging features were similar in ECG, oste0myelitis and Ewing＇s sarcoma, including destruction or sclerosls,periosteal reaction （proliferation or ossification ）,bone marrow edema,soft tissue swelling or masses,but sometimes variability was also obvious. Conclusion Comprehensive analysis of imageology characteristics of these three kinds of diseases can greatly help to make diagnosis and differentiation.