地中海贫血性骨病变的CT、MRI表现

CT and MRI manifestations of bone disease in the Mediterranean anemia

目的:探讨地中海贫血性骨病变的CT、MRI表现及诊断要点,提高该病的诊断水平。方法:回顾性分析17例地中海贫血性骨病变的CT、MRI资料,结合文献,探讨其影像特点及鉴别诊断。结果:17例胸腰椎椎体及附件均受累,其中4例合并颅骨病变,2例合并股骨及胫腓骨病变,5例合并肋骨、胸骨及肩胛骨病变。MRI见骨髓弥漫性信号异常,T_1WI骨髓高信号弥漫性降低,T_2WI呈等信号,STIR T_2WI呈高信号。CT示胸腰椎椎体呈栅栏状改变,骨小梁减少、增粗;其中5例肋骨、胸骨及肩胛骨膨胀改变,4例颅骨板障增厚、板障间呈放射状排列骨小梁;合并椎旁软组织肿块11例,合并肋骨旁软组织肿块4例,增强扫描肿块轻度均匀强化,穿刺活检示髓外造血组织。结论:地中海贫血性骨病变影像学表现有一定的特征,结合病史,可作出正确诊断。

Objective：To explore CT,MRI imaging findings and the diagnostic points of Mediterranean anemia bone lesions,so as to improve the diagnostic level of this disease. Methods：Retrospectively analyze 17 cases CT, MRI images of thalassemia os- teodystrophy combined with literature,to investigate the imaging features and differential diagnosis. Results： 17 cases of thoracic and lumbar vertebral body and accessories were involved,including 4 cases with skull lesions,2 cases with femoral,tibia and fibula lesions. MRI showed bone marrow diffuse abnormal signal,the signal on T1WI and T2WI were isointensity,and stir T2WI showed high signal;CT findings of thoracic and lumbar vertebral palisading change,bone trabeculae reduce,thickening;5 cases showed fibs,sternum and scapula expansion change,4 cases had skull diploic thickening and radial arrangement of the trabeculae in diploe;combined with paravertebral soft tissue mass in ll cases,combined rib adjacent soft tissue mass in 4 cases,the mass mild homogeneous enhanced in enhancement scanning and biopsy showed extramedullary hematopoietic tissue. Conclusion： Thalassemia osteodystrophy imaging has certain characteristics,combining with the history,we can make the correct diagnosis.