巨细胞修复性肉芽肿的影像学表现及鉴别诊断  

Imaging Findings and Differential Diagnosis of Giant Cell Repair Granuloma

作　　者：张佳 蒋元明[1] 薛凤麟[2] 沈进[1] 严俊[1] 赵卫[1] 魏佳璐 何波[1] ZHANG Jia;JIANG Yuanming;XUE Fenglin(Medical Imaging Department of the First Affiliated Hospital of Kunming Medical University ,650032,P.R.China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,650032 [2]昆明医科大学第一附属医院病理科,650032

出　　处：《临床放射学杂志》2019年第5期796-799,共4页Journal of Clinical Radiology

摘　　要：目的回顾性分析巨细胞修复性肉芽肿(GCRG)的CT和MRI表现,提高对GCRG的认识和诊断率。方法搜集经病理证实并有相关影像学检查资料的GCRG患者6例, 6例皆行CT检查,其中3例同时行MRI检查,比较并分析其特征性影像学表现及其与周围骨质关系。结果 CT表现为密度不均的软组织肿块影,并伴有邻近骨质的破坏;MRI信号与病灶成分相关,典型表现为T_2WI、T_1WI及DWI均为低信号,当伴有囊变、出血或其他变性时,T_1及T_2会有信号的改变;有时病变内可有液-液平表现。结论 CT显示密度不均肿块伴邻近骨质溶骨性破坏但骨皮质保持完整时,需考虑GCRG。MRI对其成分诊断较有特异性。CT及MRI可作为GCRG术前诊断及术后监测较好的无创检查方法。Objective To review and analyze the CT and MRI manifestations of giant cell reparative granuloma,and to improve the recognition and diagnosis of giant cell reparative granuloma. Methods 6 cases of giant cell reparative granuloma confirmed by pathology and related imaging examinations were collected. 6 cases underwent CT examination,and 3 cases underwent MRI examination simultaneously. Analyses and comparison of the characteristic imaging findings and their relationship with the surrounding bone was done. Results CT showed non-uniform density soft tissue mass accompanied by destruction of adjacent bone lesions. The typical MRI signal related to its components showed low signal on T2WI,T1WI and DWI,while associated with cystic degeneration,hemorrhage or other T1 and T2 abnormal signals will have the signal change. Sometimes lesions may possess fluid-fluid levels. Conclusion CT appearances Heterogeneous soft-tissue density mass with adjacent bone destruction,with an intact bone cortex should be considered for GCRG. CT and MRI can be used as a noninvasive method for preoperative diagnosis and postoperative monitoring of GCRG. The main points of diagnosis are(1) soft tissue mass with adjacent bone destruction(2) expansile osteolytic destruction of bone but intact cortical bone.

关 键 词：巨细胞修复性肉芽肿 骨质 计算机体层成像 磁共振成像 

分 类 号：R597.6[医药卫生—内科学] R445.2[医药卫生—临床医学] R816