骨软骨瘤继发滑囊形成的影像学分析  

Analysis of bursa formation associated with osteochondroma

作　　者：方字文[1] 郭永飞[1] 余水全[1] 刘树学[1] FANG Zi-wen;GUO Yong-fei;YU Shui-quan;LIU Shu-xue(Department of Radiology,The Traditional Chinese Medicine Hospital of Zhongshan,Guangdong 528400,China)

机构地区：[1]中山市中医院医学影像科,广东中山528400

出　　处：《影像诊断与介入放射学》2020年第5期329-333,共5页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探讨骨软骨瘤继发滑囊形成的影像表现,以提高对本病的诊断水平。方法回顾性分析12例经手术病理证实的骨软骨瘤继发滑囊形成病例的临床及CT、MRI资料。12例患者中,2例行CT平扫,3例行MRI,7例同时行CT和MRI检查。结果12例中,4例发生于肩胛骨(左侧2例,右侧2例),5例发生于股骨小转子(左侧3例,右侧2例),1例发生于左股骨远段,1例发生于右腓骨远段,1例发生于左髂骨。影像表现为骨软骨瘤旁不规则形肿物,8例CT平扫呈低密度,1例呈等密度;MRI平扫,T1WI上7例呈低信号,2例呈等信号,1例呈高信号;T2WI上均呈高信号。12例滑囊内均可见壁结节及分隔影,3例同时继发滑膜骨软骨瘤病;CT及MRI增强扫描表现为滑囊壁、分隔及壁结节明显强化。结论骨软骨瘤继发滑囊形成好发于长期受磨擦部位,临床主要表现为疼痛不适及肿块增大;影像表现为骨软骨瘤旁不规则形水样密度或信号的肿物,滑囊内可见壁结节、分隔,可继发滑膜骨软骨瘤病。Objective To explore the imaging findings of the bursa formation associated with osteochondroma.Methods The clinical data,CT(12)and MRI(10)of 12 patients with pathologically confirmed bursa formation associated with osteochondromas were reviewed.Results The 12 osteochondromas were located in the left(2)or right(2)scapula,left(3)or right(2)lesser femoral trochanter,distal left femur(1),distal right fibula(1),or left iliac bone(1).All 12 bursae appeared as irregular masses overlying the osteochondromas.The bursae were hypodense(8)or isodense(1)on CT,hypointense(7),isointense(2)or hyperintense(1)on T1-weighted MRI.All 12 bursae had high signal intensity on T2-weighted MRI.All bursae contained contrast-enhancing mural nodules and septa.Three bursae had secondary form of synovial osteochondromatosis.Conclusion Bursa formation associated with osteochondroma frequently occurs at sites with motion and friction.The most common clinical presentation includes pain and an enlarging mass.On imaging,the bursa appears as a fluid-filled mass overlying the osteochondroma and may contain mural nodules,septa and secondary synovial osteochondromatosis.

关 键 词：骨软骨瘤 外生骨疣 滑囊 软骨肉瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44