地中海贫血患者颅骨及胸部CT、MRI影像学特点分析

CT and MRI features of skull and chest in patients with Mediterranean anemia

目的探讨地中海贫血患者颅骨及胸部CT、MRI的影像表现及诊断要点,以减少误诊。方法回顾性分析18例地中海贫血并有颅骨及胸部影像改变的患者临床及CT、MRI影像表现,并且结合文献分析其病因、病理、影像特点,讨论其鉴别诊断。结果 CT、MR扫描提示胸部团块影,椎旁单发4例,多发10例,胸壁单发1例,胸壁多发2例,纵隔合并胸壁1例,椎体CT、MRI表现呈栅栏状改变,骨小梁减少增粗,肋骨端及肋骨膨大,骨皮质变薄,8例增强扫描肿块轻度均匀强化。颅骨MRI扫描颅板均匀增厚。结论颅骨颅板增厚,椎体呈栅栏网格状改变,肋骨及肋骨端膨大,胸椎旁及胸壁肿块影是地中海贫血的CT、MRI影像特点。

Objective To investigate CT and MRI features of skull and chest in patients with Mediterranean anemia to reduce misdiagnosis. Methods The clinical and CT and MRI features of 18 patients of Mediterranean anemia with the skull and chest imaging changes were retrospectively analyzed. The cause, pathology and imaging characteristics were analyzed and the differential diagnosis were discussed. Results CT and MRI scans showed chest lump shadows. There were 4 cases of single vertebral, 10 cases of multiple - vertebral, 1 case of single chest wall, 2 cases of multiple - chest wall and 1 case of mediastinal combined chest wall. Vertebral MRI, CT scanning showed a fence - like change, bone trabeculas were decreased and thickened, ribs were enlarged, cortex was thiner. Enhancement scanning showed lumps with slight enhancement. Skull MRI scanning showed the skull plates were thickening. Conclusion CT and MRI features of skull and chest in patients with Mediterranean anemia include thic- ker skull plate, vertebral body with a fence - like change, enlarged ribs.