病变周围骨髓及软组织水肿征象在良性骨肿瘤和骨肿瘤样病变中的表现特征  

Significance of intra-and extraosseous edema accompanying benign tumors and tumor like diseases

作　　者：陈海松[1] 李晓飞[1] 耿青[1] 孙欣[1] 冯卫华[1] 唐立岷[1] 

机构地区：[1]青岛大学附属医院放射科,266003

出　　处：《中华放射学杂志》2015年第3期199-202,共4页Chinese Journal of Radiology

基　　金：山东省科技发展计划（2011YD18021）

摘　　要：目的 探讨病变周围骨髓及软组织水肿征象在良性骨肿瘤和骨肿瘤样病变中的发生率和表现特征.方法 回顾性分析经手术病理证实,且有完整X线片、CT、MR平扫资料的245例良性骨肿瘤或肿瘤样病变患者资料.良恶交界性肿瘤、合并病理骨折和颅骨病变患者不纳入观察.在MRT2WI脂肪抑制像上观察肿瘤周围骨髓及软组织水肿的发生率,对有周围水肿患者对照病理结果,统计出现此征象的良性骨肿瘤或肿瘤样病变种类和术前影像诊断误诊情况.对周围水肿在各良性骨肿瘤及肿瘤样病变中发生率的比较采用x2检验.结果 91例可见病变周围水肿,发生率为37.1％（91/245）,包括Langerhans细胞组织细胞增生症23例（85.2％,23/27）,骨母细胞瘤17例（85.0％,17/20）,骨样骨瘤29例（93.6％,29/31）,软骨母细胞瘤20例（87.0％,20/23）.上述疾病中周围水肿征象出现率的差异无统计学意义（x2=6.35,P＞0.05）.2例骨毛细血管瘤均有周围水肿,其他良性肿瘤或肿瘤样病变患者均未表现为周围水肿.41例术前误诊为恶性骨肿瘤,误诊率为45.1％（41/91）.结论 病变周围水肿是良性骨肿瘤和肿瘤样病变的一种常见征象,多见于Langerhans细胞组织细胞增生症、骨母细胞瘤、骨样骨瘤、软骨母细胞瘤.Objective To explore the incidence and significance of intra-and extraosseous edema accompanying benign tumors and tumor like diseases.Methods Imaging studies including MR,CT and plain radiograph were retrospectively reviewed in 245 cases of benign osseous tumors and tumor like diseases proved by pathology（borderline tumor,cases associated with pathological fractures,cases with lesions of skull were excluded from the study）.The incidence of bone marrow and soft tissue edema were defined on T2WI with fat suppression on MRI in all the cases.x2 test was performed for the incidence rate of edema in the benign tumors and tumor like diseases.The pre-operative diagnoses were reviewed,and the influence of edema to the differential diagnosis between the benign and malignant was analyzed.Results The total incidence of bone marrow and soft tissue edema associated with benign tumors and tumor like diseases was 37.1％ （91/245）,which included Langerhans cell histiocytosis 85.2％ （23/27）,osteoblastoma85.0％ （17/20）,osteoid osteoma93.6％ （29/31）,ehondroblastoma 87.0％ （20/23）.There was no statistically significant difference of edema incidence among the above-mentioned four diseases.（x2=6.35,P＞ 0.05）.Both cases of endosteal capillary hemangioma had edema around.No edema was found around the lesions of other kinds of diseases.41 of 91 cases （45.1％） with edema were misdiagnosed as malignant tumor by MRI pre-operatively.Conclusion The marrow and soft tissue edema is a common sign in the benign bone tumor and tumor-like diseases,and it is frequently seen in Langerhans cell histiocytosis,osteoblastoma,osteoid osteoma,chondroblastoma.

关 键 词：骨肿瘤 磁共振成像 水肿 

分 类 号：R738.1[医药卫生—肿瘤]