骨上皮样血管内皮瘤的CT、MRI及18 F-FDG PET/CT表现(附2例报道)

CT,MRI and 18 F-FDG PET/CT features of primary bone epithelioid hemangioendothelioma:report of two cases and literature review

目的探讨骨上皮样血管内皮瘤(EHE)的CT、MRI及18 F-FDG PET/CT表现,以提高对该病的影像学认识。方法回顾性分析2例经病理证实的骨上皮样血管内皮瘤患者的CT、MRI及18 F-FDG PET/CT检查图像资料,总结其影像特点。结果2例骨EHE中,1例为全身多发骨骼病变,1例仅为胸11椎体病变。CT表现病灶为边缘清晰,轻度硬化并呈分叶状改变的膨胀性溶骨性骨质破坏,病灶内见散在斑点状高密度影,周边软组织及椎间盘未见明显受累。MRI病灶呈稍长T 1、长T 2信号,其内可见散在斑点状低信号影,增强扫描病灶呈明显不均匀强化。病灶外周可见增强无强化的低信号环。18 F-FDG PET/CT主要表现为病灶部位的溶骨性骨质破坏伴SUV摄取值的升高。结论CT、MRI及18 F-FDG PET/CT检查能帮助评估骨上皮样血管内皮瘤的病灶性质及范围,协助下一步诊疗方案的确定。

Objective To investigate the CT,MRI and 18 F-FDG PET/CT manifestations of bone epithelioid angioendothelioma(EHE)in order to improve the imaging understanding of the disease.Methods CT,MRI and 18 F-FDG PET/CT images of 2 pathologically confirmed patients with bone epithelioid angioendothelioma were analyzed retrospectively.And the characteristics were summarized.Results 1 case had multiple bone lesions and 1 case was located in the thoracic 11 vertebral body only.On CT,the lesion showed clear margins,mild sclerosis and lobulated changes in the swelling osteolytic bone destruction,scattered patchy high-density shadow in the lesion,and no obvious involvement in the surrounding soft tissue and intervertebral disc.On MRI,lesions showed slightly long T 1 and long T 2 signals,and scattered low-signal speckled shadows were seen.The lesions on enhanced scan showed obvious uneven enhancement.There were long T 1,short T 2 and low signal rings without enhancement around the lesion.18 F-FDG PET/CT mainly showed osteolytic bone destruction with the increase of SUV uptake.Conclusion CT,MRI and 18 F-FDG PET/CT examination can help evaluate the lesions and scope of bone epithelioid angioendothelioma,and assist in the determination of the next diagnosis and treatment plan.