颅骨孤立性浆细胞瘤的CT、MRI诊断与鉴别诊断

CT and MRI diagnosis with differential diagnosis of solitary plasmacytoma of skull

目的探讨颅骨孤立性浆细胞瘤的CT和MRI征像,提高对此病的认识和诊断水平。方法选取本院经手术和病理证实的18例颅骨孤立性浆细胞瘤患者的资料,回顾性分析其CT和MRI征象。结果CT表现为单发、溶骨性膨胀性骨质破坏及稍高密度或略混杂密度的双凸状软组织肿块,骑跨于颅内外生长,局部脑实质受压移位,无骨质硬化征象和骨膜反应,增强可见明显强化;MRI检查显示孤立性、溶骨性骨质破坏及双凸状软组织肿块,T1WI呈等或稍低信号,T2WI呈等或稍高信号,信号常均匀,少数病例信号略混杂,增强扫描常明显均匀强化,少数不均匀强化。结论CT及MRI检查两者结合,能够清楚显示颅骨孤立性浆细胞瘤的病变范围和性质、颅骨情况及其与周围组织的关系,对颅骨孤立性浆细胞瘤的诊断与鉴别诊断具有重要价值。

Objective To investigate CT and MRI features of solitary plasmacytoma of skull,so as to improve the understanding and diagnosis of the disease.Methods The data of 18 patients with solitary plasmacytoma of skull confirmed by operation and pathology in our hospital from August 2017 to June 2020 were collected,and their CT and MRI signs were analyzed retrospectively.Results CT showed solitary,osteolytic expansive bone destruction and slightly high density or slightly mixed density biconvex soft tissue mass,which grew in and out of the skull,local brain parenchyma was compressed and displaced,no signs of osteosclerosis and periosteal reaction,and obvious enhancement could be seen.MRI showed solitary,osteolytic bone destruction and biconvex soft tissue mass,T1WI showed iso-or slightly hypointense,T2WI showed iso-or slightly hyperintense,the signal was often homogeneous,a few cases had slightly mixed signals.Enhanced scan often showed obvious uniform enhancement and a few cases had inhomogeneous enhancement.Conclusion The combination of CT and MRI can clearly show the range and nature of skull solitary plasmacytoma,the condition of skull and its relationship with surrounding tissues,which is of great value in the diagnosis and differential diagnosis of skull solitary plasmacytoma.