骨孤立性浆细胞瘤的影像学表现

Imaging manifestations of solitary plasmacytoma of bone

目的探讨骨孤立性浆细胞瘤的X线摄影、CT和MRI影像学特点。方法选取经手术病理证实的17例骨孤立性浆细胞瘤患者的X线摄影、CT和MRI资料,并对其回顾性分析。结果17例骨孤立性浆细胞瘤中,脊柱11例,长管状骨3例,扁骨2例,不规则骨1例。X线摄影及CT检查:不同程度膨胀、溶骨性骨质破坏,边界不清楚。10例周围见少许硬化边。8例见骨嵴影,2例椎体内骨嵴迂曲、硬化构成“微脑征”。8例骨皮质呈虫噬样或穿凿样,2例呈“花边征”。11例周围形成软组织肿块,8例合并病理骨折。MRI检查:T1WI 2例呈等低信号,4例呈等信号,1例呈等高信号;T2WI 4例呈等高信号,3例呈高低混杂信号。2例MRI增强扫描呈明显均匀强化。结论骨孤立性浆细胞瘤影像学表现不典型,将X线摄影、CT及MRI相互结合提高诊断准确率。

Objective To analyze the X-ray,CT and MRI findings of solitary plasmacytoma of bone,so as to improve its diagnostic accuracy.Methods X-ray,CT and MRI findings of 17 cases of solitary plasmacytoma of bone proved pathologically were analyzed retrospectively.Results In 17 patients with solitary plasmacytoma of bone,11 cases were in the spine,3 cases were in the long bone,2 cases were in the flat bones,and 1 case was in the irregular bone.X-ray and CT exam showed,all of the bones were destruction emphysematose and osteolysis,with obscure boundary.10 cases of margin could see perilesional osteosclerosis.10 cases could see bone-cristae,2 bone-cristae were circuitous and hardening and formed the syndrome of“mini brain”.8 cases of cortical bone were like worm-phagy or punched-out defect,with 2 lesions showing a lace-like of cortical bone.11 cases could see soft tissue masses around.Pathologic fracture could be seen in 8 cases.By MRI,we could see 2 cases with middle-low mixed signal,4 cases with middle signal,1 case with middle-high signal on T1WI and 4 cases with middle-high signal,3 cases with high and low mixed signal on T2WI.On MRI enhancement scanning,2 cases showed a clear obviously homogeneous enhancement.Conclusion Solitary plasmacytoma of bone is uncommon.Full understanding X-ray,CT,MRI characteristic are useful to improve the diagnosis and guide clinical surgical treatment and forecast prognosis.