颅面骨巨细胞修复性肉芽肿影像分析及鉴别诊断

Imaging diagnosis of craniofacial giant cell reparative granuloma

目的总结发生于颅面骨的巨细胞修复性肉芽临床及影像学特点,提高对该病的诊断水平。方法回顾分析8例位于颅面骨经手术病理诊断为巨细胞修复性肉芽肿病例的影像特点。结果本组8例患者中其中5例术前行CT及MRI检查,2例行CT检查,1例行MRI检查。病变累及颞骨、蝶骨、乳突、骨性外耳道、额骨眶部及下颌骨。CT表现为膨胀性溶骨性骨质破环,骨皮质变薄,可见不均匀软组织密度影。MRI表现为T1WI等低信号、T2WI不均匀低信号,可见囊变坏死区域,增强扫描呈轻中度强化。结论颅面骨巨细胞修复性肉芽肿CT及MRI图像具有一定的特征,可结合影像特征及临床检查结果与其他发生于颅面部的肿瘤性病变进行鉴别诊断。

Objective To assess the imaging characteristics of giant cell reparative granuloma in the craniofacial bone.Methods CT and MRI of 8 histologically confirmed giant cell reparative granulomas in craniofacial bones were retrospectively analyzed.Results On preoperative CT and MRI(5),preoperative CT(2),and MRI(1)in 8 patients,the lesions involved the temporal bone,sphenoid bone,mastoid process,bony external acoustic meatus,frontal orbital bone,and mandible.CT showed expansile bony destruction,thinning of bone cortex and heterogeneous soft tissue density.MRI showed T1 hypointensity and heterogeneous T2 hypointensity with mild to moderate enhancement as well as non-enhanced areas of cystic degeneration and necrosis.Conclusion CT and MRI features of giant cell reparative granuloma can aid differential diagnosis from other tumorous lesions of craniofacial bone.