长骨孤立性浆细胞瘤的影像学表现  

Imaging features of solitary plasmacytoma of long bones

作　　者：李锋[1,2] 朱李茹[3] 王仁法[1] 李勇刚[4] 祁良[1] 夏黎明[1] 王承缘[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030 [2]襄阳市中心医院放射科,湖北441021 [3]襄阳市中心医院核医学科,湖北441021 [4]苏州大学附属第一医院放射科,江苏215006

出　　处：《放射学实践》2011年第8期875-878,共4页Radiologic Practice

摘　　要：目的:探讨四肢长骨骨孤立性浆细胞瘤的影像学表现。方法:回顾性分析11例经手术或穿刺活检病理证实的四肢长骨骨孤立性浆细胞瘤的临床及影像学资料,分析其影像学征象。观察指标包括骨质破坏形态、骨皮质改变、骨膜反应、MRI信号特征、瘤周骨髓水肿、软组织改变以及MRI增强改变等。结果:11例肿瘤发生在肱骨4例,股骨7例。11例在X线片和CT上均呈溶骨性骨质破坏伴有轻度的膨胀,边界较清。10例骨皮质变薄,1例骨皮质增厚。9例可见骨皮质呈虫蚀样或锯齿状骨质破坏,未见骨膜反应。所有病例均未见瘤周骨髓水肿,且均可见软组织侵犯,3例可见明显的软组织肿块。与肌肉信号相比,10例T1WI表现为稍高信号,1例呈等信号,11例T2WI表现为高信号。MRI增强扫描,大部分病例表现为明显均匀性强化,仅1例中央可见无强化区。结论:四肢长骨骨孤立性浆细胞瘤的影像学表现具有一定的特征性,X线、CT和MRI综合评价有助于提高四肢长骨骨孤立性浆细胞瘤的诊断准确性。Objective：To describe and analyze imaging appearances of solitary plasmacytoma of long bones,including radiographic,CT,and MR imaging features.Methods：We retrospectively reviewed eleven pathologically proven cases of solitary plasmacytoma of long bones.Evaluation included lesion location,pattern of bone destruction,cortical bone abnormality,periosteal reaction,peritumoral edema,soft-tissue invasion,MRI signal characteristics and contrast-enhancement pattern of solitary plasmacytoma of long bones.Results：The bones involved were the humerus（n=4） and femur（n=7）.Common appearances were an expansile osteolytic lesion with relative clear border in 10 cases showing cortical thinning of bone and 1 case showing cortical thickening of bone.Permeative or moth-eaten pattern was seen in 9 cases.Periosteal reaction and peritumoral edema were not found in all the cases.Soft-tissue invasion was present in 9 cases.An associated soft-tissue mass was apparent in 3 cases.On MRI,solitary plasmacytoma of long bones showed homogeneous slight hyper-（n=9） or iso-（n=1） intensity to muscle on T1-weighted MR images and hyperintensity on T2-weighted MR images（n=11）,and prominent homogeneous enhancement after injection of contrast medium,except for one huge plasmacytoma with central nonenhancing area due to necrosis.Conclusion：Most of solitary plasmacytoma of long bones have some specific imaging features.Radiography,CT and MR imaging can suggest the diagnosis,particularly when a expansile osteolytic lesion of long bone with permeative or moth-eaten pattern and prominent homogeneous enhancement is seen without periosteal reaction and peritumoral edema.

关 键 词：浆细胞瘤 骨肿瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738[医药卫生—肿瘤]