血友病性假肿瘤的临床及影像表现  

Clinical and Imaging Manifestations of Hemophilia Pseudotumor

作　　者：孟帆 黎海亮 袁军辉 韩帅 王立峰 蒋辉 刘翠翠 邵楠楠 MENG Fan;LI Hai-liang;YUAN Jun-hui;HAN Shuai;WANG Li-feng;JIANG Hui;LIU Cui-cui;SHAO Nan-nan(Department of Radiology,the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属肿瘤医院/河南省肿瘤医院放射科,河南郑州450000

出　　处：《河南医学研究》2020年第16期2902-2905,共4页Henan Medical Research

摘　　要：目的探讨血友病性假肿瘤的临床及影像表现。方法回顾性分析2010年1月至2019年6月郑州大学附属肿瘤医院/河南省肿瘤医院收治的13例经临床及病理证实的血友病性假肿瘤患者的资料。9例患者接受DR检查;7例患者接受CT检查,1例患者接受增强CT检查;11例患者接受磁共振平扫,6例患者接受磁共振增强检查。统计血友病性假肿瘤的部位、大小、形态、密度、骨质破坏、强化程度及周围组织受压等表现。结果 13例患者:7例单发病灶,6例多发病灶;7例肌间型,6例骨膜下型,3例骨内型,1例关节腔内,1例腹腔内;位于股骨3例,胫骨1例,下肢肌群3例,臀部2例,髂骨2例,髂腰肌4例,腹腔内1例,肋骨1例。假肿瘤最大径为24~298 mm,中位最大径为94 mm,其中6例假肿瘤的最大径>100 mm。X线和CT表现:9例软组织肿块,呈高低混杂密度,7例边界较清;3例膨胀性骨质破坏,2例伴病理性骨折;1例囊样型骨质破坏;1例压迫吸收;6例破坏边缘伴增生硬化,2例见骨皮质翘起及骨膜刺样增生。CT增强显示临近血管明显受压。MRI表现:11例平扫显示骨质破坏区及软组织肿块T2WI、T1WI和DWI均呈高低混杂信号,肿块边界较清,边缘可见厚包膜,6例肿块内见分隔;6例增强均未见强化。结论血友病性假肿瘤在临床及影像表现上具有一定的特征性。此类患者的CT示高低混杂密度肿块,部分病灶内存在多发钙化影,伴或不伴有临近骨质破坏,骨质破坏表现多样;MRI各序列均表现为高低混杂信号,边界较清,可见包膜和多发分隔,临近血管受压明显,增强不强化。Objective To investigate the clinical and imaging manifestations of hemophilia pseudotumor.Methods The clinical data of 13 patients with hemophilia pseudotumor in the Affiliated Cancer Hospital of Zhengzhou University(Henan Cancer Hospital) from January 2010 to June 2019 were retrospectively analyzed. Among which, 9 patients were examined by DR, and 7 patients were examined by CT plain scanning, while 1 patients received enhanced CT examination. And 11 patients were examined by MRI plain scan, while 6 patients were examined by MRI contrast enhancement. The site, size, morphology, density, bone destruction, enhancement and surrounding tissue compression of hemophilia pseudotumor were also analyzed.Results Among the 13 patients, 7 cases were single lesions, while the other 6 cases were multiple lesions. There were 7 cases of intermuscular type, 6 cases of subperiosteal type, 3 cases of intra-osseous type, 1 case of intra-articular cavity and 1 case of intra-abdominal cavity. Three patients were located in the femur, 1 case in the tibia, 3 cases in the lower extremity muscle group, 2 cases in the buttocks, 2 cases in the iliac bone, 4 cases in the iliopsoas muscle, 1 case in the abdominal cavity and 1 case in the ribs. The maximum diameter of pseudotumor was 24 to 298 mm, and the median maximum diameter was 94 mm. The maximum diameter of 6 cases of hemophilia pseudotumor was more than 100 mm. There were 9 cases of soft tissue masses with high and low mixed density, while 7 cases with clear boundary. Three cases had shown with expanded bone destruction and 2 cases with pathologic fracture. Cystic bone destruction were found only in 1 case. Compression absorption were also found in 1 case. The destruction margin which accompanied by hyperplasia and sclerosis were found in 6 cases, while an upturned bone cortex and periosteum spinous hyperplasia were observed in 2 cases. CT enhancement revealed significant compression of adjacent vessels. MRI findings: 11 cases had demonstrated with a bone destruction area and soft tis

关 键 词：血友病性假肿瘤 磁共振成像 X线计算机 

分 类 号：R554[医药卫生—血液循环系统疾病]