脊柱嗜酸性肉芽肿的影像学分析  

Imaging features of eosinophilic granuloma of spine

作　　者：王亚捷[1] 杨帆[1] 葛微[1] 孙念念[1] 潘诗农[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,辽宁沈阳110004

出　　处：《医学影像学杂志》2016年第2期319-323,共5页Journal of Medical Imaging

基　　金：盛京自由研究者基金资助项目(编号:201208)

摘　　要：目的分析脊柱骨嗜酸性肉芽肿的特征性影像表现,并与椎体其他骨病相鉴别。方法回顾分析我院28例经手术病理或活检证实为脊柱嗜酸性肉芽肿的影像学表现,其中DR 21例,CT 15例,MRI 10例,ECT 5例,PET/CT 2例。23例单发,5例多发,颈椎9个,胸椎15个,腰椎12个。结果 DR示病变椎体形态变扁,密度增高;CT表现病椎不同程度骨质破坏,部分病灶周围高密度硬化缘;MRI示椎体信号改变及椎旁软组织肿块,椎间盘信号及椎间隙正常;ECT及PET/CT可显示病椎核素浓聚情况,提示病变是否处于进展期。结论脊柱嗜酸性肉芽肿的影像学有一定特征,结合临床表现及病理,注意与其它椎体骨病鉴别,提高对本病的认识。Objective To summarize the imaging features of eosinophilic granuloma in spine and to discuss the reasons of misdiagnosis. Methods We retrospectively evaluated the imaging characteristics of 28 patients suffering from eosinophilic granuloma in spine confirmed by pathology. The method of image examination included DR,CT,MRI,ECT and PET / CT. Results The 21 patients examined by DR showed the shape of vertebrae turned to flat,and deasity increased. 15 cases examined by CT demonstrated destruction of bone in different degree with surrounding ostosis. 10 cases checked by MRI showed isointensity or hypointensity in T1 WI and hyperintensity in T2 WI,and the signal of intervertebral disc was normal,and swollen soft tissue around the vertebrae showed oversleeve like. Five cases checked by ECT and two by PET / CT showed radioactivity concentration on abnormal vertebrae. Conclusion The eosinophilic granuloma in vertebrae showed some specific imaging characteristics. Combined with clinical manifestations and histopathology may improve the ability of diagnosis and differerential diagnosis.

关 键 词：脊柱 嗜酸性肉芽肿 影像 

分 类 号：R738.1[医药卫生—肿瘤] R445[医药卫生—临床医学]