摘要
目的:探讨儿童颅骨筋膜炎(CF)的临床及影像学特征,旨在提高对其认识。方法:回顾性分析、总结经本院手术及病理证实的13例颅骨筋膜炎的临床及CT、MRI资料,13例患儿行CT检查,3例行MRI检查,其中1例CT及MRI增强检查,手术切除后进行了8~61个月随访。结果:13例CF中,男7例,女6例,年龄3个月~12岁8个月,平均46.7个月。13例均表现为质硬、无痛且活动性差的头皮肿块。短期内,2例(15.4%)体积迅速增大,6例(46.2%)缓慢增大。CT表现分为三型:Ⅰ型(7例,53.8%)表现为膨胀性溶骨性骨质破坏伴软组织肿块;Ⅱ型(2例,15.4%)表现为非膨胀性溶骨性骨质破坏伴软组织肿块;Ⅲ型(4例,30.8%)表现为头皮肿块压迫相邻颅骨,颅骨受压变薄/吸收破坏。13例中,12例软组织包块为等或稍高密度,1例为低密度,包块边界清晰。3例行MRI检查患儿中,1例软组织包块信号均匀,2例不均匀,其中1例行增强扫描后呈环形增强。随访中4例(30.8%)复发。结论:CF是发生于儿童头皮或颅骨的无痛性的良性包块,质硬、活动度差,体积多缓慢或快速增大。CT表现分为3种类型:膨胀性溶骨性骨质破坏伴软组织肿块;非膨胀性溶骨性骨质破坏伴软组织肿块;头皮软组织包块伴骨质受压变薄/吸收破坏。软组织肿块密度及信号多变。手术后较易复发,建议扩大手术切除范围。
Purpose:To summarize the clinical and imaging characteristic features of cranial fasciitis(CF)in children,in order to improve the knowledge of radiologists and clinicians.Methods:The clinical,CT and MRI data of 13 CF patients confirmed by surgery and pathology in our hospital were analyzed and summarized retrospectively.Thirteen patients underwent a plain CT scan of the head,3 patients underwent a plain MRI scan,and 1 patient underwent CT and MRI enhancement examination.After surgery,they were followed up for 8 to 61 months.Results:The 13 CF patients(7 males and 6 females)aged 3-152 months,with an average of 46.7 months.All the 13 patients presented hard,painless and firm masses at the lesion position.In the short term,the mass increased rapidly in 2 patients(15.4%),and increased slowly in 6 cases(46.2%).The lesions were divided into three types based on CT findings:typeⅠ(7 cases,53.8%)presented as expansive and osteolytic bone destruction with a soft tissue mass;typeⅡ(2 cases,15.4%)presented as unexpansive and osteolytic bone destruction with a soft tissue mass;typeⅢ(4 cases,30.8%)presented as a scalp mass with pressure or erosion of the skull.On CT,the soft tissue masses of 12 patients were isodensity or slightly high density,and 1 was low density,of which were all with well-defined edges.On MRI,the soft tissue mass of 1 patient was homogeneous and the other 2 were heterogeneous,of which 1 patient presented circular enhancement in the MRI enhancement examination.Four patients(30.8%)recurred during follow-up.Conclusions:CF is a painless,hard and nonmobile benign mass on the scalp or skull in children.The mass can slowly or rapidly increase in a short term.CF can be divided into three types:expansive and osteolytic bone destruction with a soft tissue mass,unexpansive and osteolytic bone destruction with a soft tissue mass,a scalp soft tissue mass with bone compression thinning/absorption.The density and signal of the soft tissue masse is variable.CF is easy to recur after surgery,so we recommend an aggressive resection in order to reduce the recurrence rates.
作者
梁琼鹤
祝永杰
管红梅
LIANG Qionghe;ZHU Yongjie;GUAN Hongmei(Department of Radiology,Children’s Hospital of Nanjing Medical University;Department of Neurosurgery,Children’s Hospital of Nanjing Medical University)
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2024年第1期90-95,共6页
Chinese Computed Medical Imaging
关键词
儿童
颅骨筋膜炎
计算机体层成像
磁共振成像
Children
Cranial fasciitis
Computed tomography
Magnetic resonance imaging