长骨血管瘤的X线、MRI表现与病理对照  

Correlative Analysis on the Plain Radiographic and MRI Findings of Hemangioma in Long Bone

作　　者：王娟[1] 张家雄[1] 周守国[1] 樊长姝[1] 

机构地区：[1]广州中医药大学附属佛山中医院MR室,广东佛山528000

出　　处：《临床放射学杂志》2013年第11期1622-1625,共4页Journal of Clinical Radiology

基　　金：广东省科技计划基金资助项目(编号:2011B031800352)

摘　　要：目的探讨长骨血管瘤的X线及MRI表现及病理基础,旨在提高对其征象及鉴别诊断的认识。方法回顾性分析经病理证实的10例(男4例,女6例)长骨血管瘤患者影像资料,其中股骨4例,胫骨4例,腓骨1例,尺骨1例。所有患者均行X线平片、MRI平扫及增强扫描。结果 X线表现为多囊状骨质破坏7例,网格或蜂窝样改变2例,局灶性皮质增生改变1例。MRI上髓内型呈多囊状改变6例,T1WI呈等低信号,T2WI呈高信号,在T1WI及T2WI上病灶内及边缘见线状或纤维条索状低信号分隔;网格或蜂窝状改变2例,在T1WI及T2WI上病灶内见网格或蜂窝状低信号。骨膜型1例,骨膜下见类梭形T1WI等信号、T2WI混杂高信号;骨皮质内型1例,骨皮质局部增厚、隆起,T1WI呈等信号,T2WI呈高信号,邻近髓腔变窄。增强后均呈不均匀强化。结论长骨血管瘤X线及MRI表现多样,与病理类型有关。X线对诊断具有一定价值。MRI有助于反映病变组织成分、病变范围,对治疗方案的选择具有指导作用。Objective To investigate the plain radiography and MRI findings and pathological features of hemangioma in long bone and to improve the recognition of signs and differential diagnosis. Methods The plain radiography and MRI findings of 10 cases （4 males, 6 female） with hemangioma in long bone proved by pathology, involving the femur （n = 4）, tibia （ n = 4）, fibula （ n = 1 ） and ulna （ n = 1 ）, were retrospectively analyzed, of which all cases received plain radiograph- y and enhanced MRI. Results The plain radiographic manifestations were divided into three types： cyst type （n = 7 ）, mesh or honeycomb type （ n = 2） and localized cortical thickening type （ n = 1 ）. On MRI images, cyst type （ n = 6 ） ap- peared iso or hypointensity on Tl WI and heterogeneous hyperintensity on T2WI, and linear hypointensity inside and around the lesions on T1WI and T2WI. Mesh or honeycomb type （n = 2） appeared mesh and hypointensity on T1 WI and T2WI. Periosteal type （ n = 1 ） appeared spindle shaped lesion under periosteal. Cortical bone type （n = 1 ） appeared localized cor- tical thickening and medullary cavity narrowing. On enhanced MR images, lesions were heterogeneous enhanced. Conclu sion The plain radiography and MRI findings of hemangioma in long bone is varied and relevant to pathological type. Plain film has certain diagnostic value. MRI can reflect the variable pathologic elements and the scope of the lesions, which is useful for clinic treatment.

关 键 词：长骨 骨血管瘤 放射摄影术 磁共振成像 组织病理学 

分 类 号：R738.1[医药卫生—肿瘤]