颅骨筋膜炎的影像学特征  

Imaging features of cranial fasciitis

作　　者：赵彩蕾[1] 江贤萍[2] 夏军[4] 苏琪茹 胡俊杰 黎耀文 徐守军[1] 孟宪磊[1] 干芸根[1] ZHAO Cailei;JIANG Xianping;XIA Jun;SU Qiru;HU Junjie;LI Yaowen;XU Shoujun;MENG Xianlei;GAN Yungen(Department of Radiology,Shenzheng Children’s Hospital,Shenzhen,Guangdong Province 518000,China;Department of Pathology,Shenzheng Children’s Hospital,Shenzhen,Guangdong Province 518000,China;Clinical Laboratory,Shenzheng Children’s Hospital,Shenzhen,Guangdong Province 518000,China;Department of Radiology,Shenzhen Second People’s Hospital,Shenzhen,Guangdong Province 518000,China)

机构地区：[1]深圳市儿童医院放射科,广东深圳518000 [2]深圳市儿童医院病理科,广东深圳518000 [3]深圳市儿童医院临床研究室,广东深圳518000 [4]深圳市第二人民医院放射科,广东深圳518000

出　　处：《实用放射学杂志》2022年第2期302-306,共5页Journal of Practical Radiology

基　　金：深圳市科技创新委员会项目(JCYJ20180228175428243);深圳市医疗卫生三名工程资助项目(SZSM202011005).

摘　　要：目的分析颅骨筋膜炎(CF)的影像学特征,提高对本病的认识,帮助临床诊治.方法选取经手术病理证实为CF的13例患儿,并进行了2~10年随访.其中12例患者进行CT检查,2例进行MRI平扫及增强扫描.结果13例患儿,共14个病灶;病变与颅缝关系密切,多见贴近颅缝或跨颅缝生长.CT特征性表现分为3种:一种为软组织包块,共3/14个病灶;另外2种为颅骨病变,共11/14个病灶,其中一种为膨胀性溶骨破坏,共7个病灶,伴硬化边,其内均可见条片状骨嵴,6/7个病灶见条片状骨嵴以病变中心为核心向外周延伸,似“花瓣”样,另外一种为溶骨性骨破坏,无骨质膨胀,共4个病灶,呈“筛孔”样,病灶内软组织影常向颅骨外稍膨隆.MRI表现为T_(1)WI和T_(2)WI以等信号实性病变为主,增强后明显强化,中心可见片状不强化区,呈长T_(1)WI及长T_(2)WI信号,该边缘见明显的线状强化.结论CF生长常与颅缝关系密切,尤其冠状缝;CT特征性表现为膨胀性溶骨破坏,伴硬化边,典型表现为“花瓣”样骨嵴,以病变中心为核心条片状影向外周延伸;MRI特征为实性病变为主,明显强化,病变中心片状T_(1)WI低信号、T_(2)WI高信号,增强后不强化,边缘可见线状明显强化影.Objective To analyze the imaging features of cranial fasciitis(CF),to improve the understanding of this disease and help clinical diagnosis and treatment.Methods Thirteen patients with CF confirmed by surgical pathology were collected and fol-lowed up for 2-10 years.CT examination was performed in 12 patients,and MRI plain scan and enhanced scan were performed in 2 patients.Results There were 14 lesions in 13 children.The lesions were closely related to the cranial suture,and most of them grew close to or across the cranial suture.The characteristic manifestations of CT could be divided into three types:one type was soft tissue mass,with a total of 3/14 lesions;the other two types were skull lesions,with a total of 11/14 lesions,one of two types was expansive osteolytic destruction,a total of 7/11 lesions with sclerotic edges,in which strip-shaped bone ridges could be seen,and 6/7 lesions could see strip-shaped bone ridges,which extended outward with the lesion center as the core,like“petal”;the other one of two types,a total of 4/11 lesions,was osteolytic bone destruction,showing sieve-like,no bone swelling,without sclerotic edge,discontinu-ous disruption of the skull,often accompanied by small soft tissue masses.MRI showed that T_(1)WI and T_(2)WI were mainly iso-signal solid lesions,which were obviously enhanced after enhancement,and patchy unenhanced areas could be seen in the center,showing long T_(1)WI and long T_(2)WI signals,and obvious linear enhancement at the edge.Conclusion The growth of CF is often closely related to cranial suture,especially the coronal suture;CT is character-ized by expansive osteolytic destruction with sclerotic edge,typi-cally showing“petal”-like bone crest,with the lesion center as the core strip shadow extending to the periphery;MRI features are mainly solid lesions with obvious enhancement,with patchy T_(1)WI low signal and T_(2)WI high signal in the center of the lesion,but no enhancement after enhancement,and linear obvious enhance-ment can be seen at the edge.

关 键 词：儿童 颅骨筋膜炎 计算机体层成像 磁共振成像 

分 类 号：R681[医药卫生—骨科学] R814.42[医药卫生—外科学]