骨旁脂肪瘤4例影像学表现分析并文献复习  

Imaging analysis of 4 cases parosteal lipoma and literature review

作　　者：褚吉祥 马焕[1] 王瑶 李鹍[1] 廖承德[1] CHU Jixiang;MA Huan;WANG Yao;LI Kun;LIAO Chengde(Department of Radiology,The Third Affiliated Hospital of Kunming Medical University&Tumor Hospital of Yunnan Province,Kunming 650018,Yunnan Province,China)

机构地区：[1]昆明医科大学第三附属医院,云南省肿瘤医院放射科,云南昆明650018

出　　处：《肿瘤影像学》2022年第4期409-413,共5页Oncoradiology

基　　金：云南省基础研究计划项目(昆医联合专项)[2019FE001(-79),2019FE001(-240)]。

摘　　要：目的:分析总结骨旁脂肪瘤影像学表现特点,以提高对该病的认识。方法:对4例骨旁脂肪瘤患者的临床及影像资料进行回顾分析。结果:4例患者中,男性2例,女性2例。发生部位分别为肩胛骨、跟骨、肱骨及股骨。临床表现主要为单发、生长缓慢的无痛性肿块。X射线(X-ray)以骨旁“透光”肿块伴邻近骨皮质肥厚并骨性突起为特点。计算机体层成像(computed tomography,CT)上病变主体呈脂肪密度,类圆形或分叶状,边缘清晰,中央为“鹿角样”或“珊瑚状”骨化,与附着处增厚骨皮质或骨突连续,可有骨质侵蚀、破坏。磁共振成像(magnetic resonance imaging,MRI)上的T1加权成像(T1-weighted imaging,T1WI)为高信号,T2加权成像(T2-weighted imaging,T2WI)为高信号,脂肪抑制序列呈低信号,内见长T1、短T2信号骨化和等T1、等T2信号纤维分隔,边缘见纤维包膜,增强包膜及间隔轻微强化。结论:骨旁脂肪瘤属罕见病,具有骨旁脂肪密度或信号肿块伴骨化及邻近骨质改变等特征性影像学表现,结合CT及MRI检查,术前多可正确诊断。Objective:To analyze and summarize the imaging features of parosteal lipoma in order to improve the understanding of the disease.Methods:The clinical and imaging data of 4 patients with parosteal lipoma were analyzed retrospectively.Results:Among the 4 patients,there were 2 males and 2 females.The lesions originated in scapula,calcaneus,humerus and femur,respectively.The main clinical manifestation was a solitary and slow-growing painless mass.X-ray was characterized by parosteal“transparent”mass with adjacent cortical hypertrophy and bony protrusion.On computed tomography(CT),the lesions were quasi circular or lobulated,and performed as fat density with clear margin.The central part of the lesion showed“antler-like”or“coral-like”ossification,which was continuous with the thickened cortical bone or protrusion at the attachment.There could have bone erosion and destruction.On magnetic resonance imaging(MRI),the lesions showed mainly high-signal on T1-and T2-weighted imaging,and low-signal on fat suppression sequence.Low-signal ossification and iso-signal fiber separation could be seen in the lesions,and fibrous capsule could be seen on the margin.The capsule and fiber separation were slightly enhanced after injection of contrast agent.Conclusion:Parosteal lipoma is a rare disease with characteristic imaging manifestations such as paraosseous fat density or signal mass with ossification and adjacent bone changes.Combined with CT and MRI,it can be correctly diagnosed before operation.

关 键 词：骨旁脂肪瘤 计算机体层成像 磁共振成像 

分 类 号：R738.6[医药卫生—肿瘤] R445[医药卫生—临床医学]