骨嗜酸性肉芽肿X线、MR误诊分析及鉴别诊断  

X-ray,MRI misdiagnosis analysis and differential diagnosis of bone eosinophilic granuloma

作　　者：莫卓均[1] 张延伟[1] 李忠民 MO Zhuojun;ZHANG Yanwei;LI Zhongmin(Radiology Department,Orthopedics Hospital Affiliated to Guangzhou University of Ch#wse Medicine 510240,P.R.China;Intervention Catheter Room,Shouguang Chinese Medicine Hospital,Shouguang 262700,P.R.China)

机构地区：[1]广州中医药大学附属骨伤科医院放射科,广东广州510240 [2]山东省潍坊市寿光市中医医院介入导管室,山东潍坊262700

出　　处：《医学影像学杂志》2018年第5期845-847,851,共4页Journal of Medical Imaging

摘　　要：目的分析骨嗜酸性肉芽肿平片与MRI表现,探讨误诊原因,提高正确诊断率。方法回顾分析经穿刺/手术病理证实的43例骨嗜酸性肉芽肿患者的X线、MRI及临床表现,术前术后诊断。结果平片误诊为急性骨髓炎6例,尤因肉瘤3例,慢性骨髓炎、骨肉瘤、骨结核、淋巴瘤各2例,骨纤维结构不良、动脉瘤样骨囊肿、内生软骨瘤各1例,误诊率51.6%(16/31);MRI误诊为骨髓炎3例、Ewing肉瘤、淋巴瘤1例,误诊率为22.7%(5/22)。结论认识到本病不同部位、不同时期病变的多变性,而病变本质为肉芽肿,合理选择影像学技术,仔细分析病变的影像学征象,紧密结合临床及实验室检查,可提高本病正确诊断率。Objective To analyse the bone eosinophilic granuloma plain radiographs and MRI performance and to discuss the misdiagnosis reason,and improve the correct diagnostic rate. Methods X-ray,MRI and clinical manifestations,preoperative diagnosis of 43 patients with bone eosinophilic granuloma confirmed by biopsy/surgical pathology were analyzed retrospectively. Results Of all patients performed by X-ray radiography,6 cases were misdiagnoed for acute osteomyelitis,3 for ewing sarcoma,2 for chronic osteomyelitis,2 for osteosarcoma,2 for bone tuberculosis,2 for lymphoma,1 for osteofibrous dysplasia,1 for bone cyst of the aneurysm,and 1 for enchondroma. The misdiagnoed rate was 51. 6%（16/31）. Of 22 patients performed by MRI,3 cases were misdiagnosis for osteomyelitis,1 for Ewing＇s sarcoma,and 1 for lymphoma. The misdiagnosis rate was 22. 7%（5/22）.Conclusion If we could ecognize the variability of the different parts of the lesions,different periods of the disease,and lesions in nature as the granuloma,reasonably choose imaging technology,carefully analyze the imaging signs of disease,closely combine with clinical and laboratory examination,the correct diagnostic rate would be improved.

关 键 词：骨嗜酸性肉芽肿 X线诊断 磁共振成像 

分 类 号：R681[医药卫生—骨科学] R445.2[医药卫生—外科学]