儿童肩胛骨肿瘤的影像学诊断与鉴别

发布时间：2018-04-12 23:22

本文选题：儿童 + 肩胛骨　；参考：《临床放射学杂志》2015年12期

【摘要】：目的探讨儿童肩胛骨肿瘤的影像学表现。方法搜集21例经穿刺活检或手术病理证实的肩胛骨肿瘤患者的X线(n=21)、CT(n=14)和CT增强(n=1)检查资料,分析其病变类型、部位、发病特点和影像表现。结果良性肿瘤12例(骨软骨瘤11例、血管瘤1例),病变均位于S_1区;中间型肿瘤8例(嗜酸性肉芽肿6例,动脉瘤样骨囊肿2例),5例累及S_2区。恶性肿瘤1例(尤文肉瘤),同时累及S_1、S_2区。骨软骨瘤多表现宽或窄基底骨性凸起;血管瘤表现为溶骨性骨质破坏,边缘不清,易误诊为恶性肿瘤;嗜酸性肉芽肿呈溶骨性骨质破坏,边界清晰可伴层状骨膜反应;动脉瘤样骨囊肿呈膨胀性骨质破坏,可见典型"液-液平面"征象;尤文肉瘤表现为虫蚀样骨质破坏、放射状骨膜反应及明显软组织肿块,具有特征性。结论儿童肩胛骨肿瘤以良性及中间型肿瘤多见,骨软骨瘤均位于S_1区,以骨性突起多见,中间型肿瘤多位于S_2区,骨质破坏边界清楚,伴硬化边;而恶性肿瘤破坏范围较广,常同时累及S_1及S_2区,边界模糊,且骨膜反应明显。
[Abstract]:Objective to investigate the imaging features of scapular tumors in children.Methods the data of 21 patients with scapular tumor confirmed by puncture biopsy or surgery and pathology were collected, and the types, location, features and imaging manifestations of the lesions were analyzed.Results 12 cases of benign tumor (11 cases of osteochondroma and 1 case of hemangioma), 8 cases of intermediate tumor (6 cases of eosinophilic granuloma and 2 cases of aneurysm-like bone cyst) involved S2 region.One case of malignant tumor (Ewing sarcoma), and the involvement of S _ 1 / S _ 1 / S _ S _ 2 region.Osteochondroma showed broad or narrow basal osteoprotuberance, hemangioma showed osteolytic bone destruction with unclear margin and was easily misdiagnosed as malignant tumor, eosinophilic granuloma presented osteolytic osteolytic bone destruction with clear boundary and lamellar periosteal reaction.The typical "liquid-liquid plane" signs were found in aneurysm like bone cysts. Ewing's sarcoma was characterized by wormlike bone destruction, radial periosteal reaction and obvious soft tissue mass.Conclusion benign and intermediate tumors are more common in scapular tumors in children, osteochondroma is located in S-1 area, osteoid processes are more common, intermediate tumors are located in S2 area, bone destruction boundary is clear and sclerosing edge is clear, and malignant tumors have a wide range of destruction.At the same time, the boundary of S _ 1 and S _ 2 was blurred, and the periosteal reaction was obvious.
【作者单位】：遵义医学院附属医院影像科贵州省医学影像中心;
【分类号】：R738;R730.44

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