血友病性假肿瘤的影像特征  

The imaging characteristics of hemophilic pseudotumor

作　　者：黄晓辉 林达 陈浩 王晓阳[3] 邱乾德 Huang Xiaohui Lin Da Chen Hao Wang Xiaoyang Qiu Qiande(Department of Imaging, Wenzhou People＇s Hospital of Zhejiang Province, Wenzhou 325000, Chin)

机构地区：[1]浙江省温州市人民医院影像科,325000 [2]浙江省乐清市人民医院放射科,325600 [3]浙江省瑞安市人民医院放射科,325300

出　　处：《中华放射学杂志》2016年第12期958-962,共5页Chinese Journal of Radiology

摘　　要：目的：探讨血友病性假肿瘤影像表现特征。方法回顾分析经临床、实验室确诊的A型血友病性假肿瘤12例的DR、CT和MRI影像表现。其中行DR检查6例，CT检查9例，MRI检查5例。根据影像，对假肿瘤的部位、大小、形态、密度、骨质破坏、强化程度及周围组织受压等情况进行分析。结果病变位于股骨4例、髂骨3例、颅骨3例、跟骨2例；肌间型1例、骨膜下型2例、骨内型9例。肿瘤最大径5.0～60.0 cm，平均（19.1±6.0） cm，其中〉10.0 cm 7例。X线和CT表现：骨质呈膨胀性破坏6例，膨胀并溶骨性破坏3例，侵蚀性破坏2例，囊状并溶骨性破坏1例；骨质破坏边缘硬化10例，破坏内残留粗大骨嵴2例，伴病理性骨折2例，假Codman三角1例；软组织肿块10例，软组织肿块密度高于肌肉组织，CT值45～68 HU。行CT增强检查5例，骨质破坏区和软组织肿块均无强化，CTA示病变区和邻近血管受压移位。MRI信号表现：行MRI检查5例，骨质破坏区和软组织肿块信号于T2WI、T1WI、SPAIR和DWI均呈高、低、等混杂信号，其中病变区有多囊状改变2例，病变区有分隔2例。结论血友病性假肿瘤影像表现具有一定特征，骨质呈膨胀、囊状或侵蚀性破坏，骨皮质菲薄或消失，破坏边缘骨质硬化；软组织肿块明显，CT和MRI均呈高、低、等混杂密度信号。Objective To investigate the imaging characteristics of hemophilic pseudotumor. Methods Twelve cases of type A hemophilic pseudotumor proved by clinic and laboratory examination were included in the study. The X-ray, CT and MRI examination were performed in 6, 9 and 5 cases, respectively. The imaging appearances of 12 cases were retrospectively analyzed regarding the pseudo-tumor location, size, density, bone destruction, enhancement and the change of adjacent tissue. Results In 12 cases of hemophilic pseudo-tumors,there were 4 cases in femur,3 cases in ilium,3 cases in skull and 2 cases in calcaneus. There were intra-muscular type （n=1）,subperiosteal type （n=2） and intra-osteal type （n=9）.The size of pseudo-tumor was 5.0-60.0 cm,mean （19.1 ＆#177; 6.0） cm,and more than 10.0 cm in 7 cases. X-ray and CT demonstrated expansive bone destruction（n=6）,expansive and lytic bone destruction（n=3）,erosive bone destruction（n=2）,cystic and lytic bone destruction（n=1）;bone destruction with edge sclerosis（n=10）,thick bone crest residue within bone destruction（n=2）,bone destruction with pathologic fracture（n=2）,pseudo Codman＆#39;s triangle（n=1）,and soft tissue mass（n=10） with higher density （CT value 45-68 HU） than normal muscle. CT showed no enhancement in bone destruction and soft tissue mass in 5 cases of contrast agent enhancement and CT angiography demonstrated compression and displacement of pseudo-tumor and adjacent vessels. MRI examination （n=5） showed soft tissue masses and bone destruction with high,low and mixed signals on T2WI,T1WI,SPAIR and DWI sequences,as well as multiple cystic and separate change in pseudo-tumors（n=2, respectively）. Conclusions Hemophilic pseudo-tumor has some imaging characteristics,such as expansive,cystic and erosive bone destruction,thinning or disappearance of bone cortex,bone destruction with edge sclerosis,prominent soft tissue mass,mixed density or signal on CT or MRI,and no contrast enhancement,et al. It can be clearly

关 键 词：体层摄影术 X线计算机 磁共振成像 血友病假肿瘤 

分 类 号：R554.1[医药卫生—血液循环系统疾病]