血友病性肌骨假肿瘤临床影像学诊断与鉴别诊断  

Clinical Imaging Diagnosis and Differential Diagnosis of Hemophilia Musculoskeletal Pseudotumor

作　　者：于洪存[1] 史浩[1] 李爱银[1] 董杰[1] 刘素兰[1] 李政义[1] 姚丙乾[1] 王广丽[1] 

机构地区：[1]山东省千佛山医院影像科,济南250014

出　　处：《临床放射学杂志》2013年第3期379-383,共5页Journal of Clinical Radiology

摘　　要：目的探讨血友病性肌骨假肿瘤影像学诊断与鉴别诊断方法搜集2002至2012年在本院经临床或病理证实的血友病性肌骨假肿瘤12例,均为男性,年龄10～53岁,平均28.7岁。A型10例,B型2例;中型7例,重型5例。髂骨2例,股骨(部)5例,肱骨1例,指骨1例,膝关节2例,臀部1例。病史3个月～16年不等。X线检查12例,CT检查6例,MRI检查5例。有创伤史8例,局部疼痛8例,软组织肿胀或肿块8例,功能障碍3例,病理骨折1例,皮肤破溃1例。自幼有出血史5例。12例中,单发骨病变3例,多处肌和/或骨病变7例(其中1例病变数达12个),关节破坏或结构消失2例。结果溶骨性骨破坏2例,骨膨胀性骨破坏6例,骨膜增生3例,皮质受压变薄/局部增厚5例,软组织内肿块7例,关节破坏肿胀2例。结论血友病性肌骨假肿瘤影像学表现较具特征性,骨内和关节病变影像表现与出血多少、急慢、是否反复或持续有关;软组织内病变大小形态、密度/信号与出血部位和局部血供多少有关。Objective To study imaging findings and differential diagnosis of hemophilia musculoskeletal pseudotu- mot. Methods Of 12 patients, all cases were men, A type （10 cases）, B type（ 2 cases） and moderate （7 cases）, and severe （5 eases） ; history range （3M - 16Y） ; age （ 10 -53 years ） ,average 28.7 years older; Location were distributed at ilium, femur, humerus, phalanx and knee. X ray（ 12 cases） and CT（6 cases） , MRI（5 cases）were performed. Scar histo- ry （8 cases ）, local pain （ 8 cases ）, swelling or soft tissue mass （ 8 cases ）, dysfunction （ 3cases ）, pathological fracture （ 1 case） were found. Skin changes included burst, dark, skin temperature increased, skin shiny, no varicose veins. Bleed- ing history was found in 5 cases. Single bone lesion was seen in 3 cases ; more muscle lesions and/or more bone lesions were found in 7 cases, joint destruction or structure disappear in 2 case. Results Osteolytic destruction was seen in 2 cases, bone expansion in 6 cases, periosteal proliferationin 3 cases, soft tissue mass in 7 cases and joint destruction in 2 cases. Conclusion There are some image characteristics in hemophilia pseudotumor, image findings of bone and joint disease are relative to how much bleeding, acute or chronic and repeatedly bleeding; image findings of soft tissue lesions are related to bleeding site and local blood supply.

关 键 词：血友病 肌骨 假肿瘤 影像学 诊断 

分 类 号：R554.1[医药卫生—血液循环系统疾病]