胸部髓外造血与髓脂肪瘤的CT与MRI鉴别诊断

发布时间：2018-03-23 15:21

本文选题：胸部　切入点：髓外造血　出处：《临床放射学杂志》2015年10期

【摘要】：目的探讨胸部髓外造血与髓脂肪瘤的影像鉴别诊断特征。方法回顾分析经病理证实的5例髓外造血与2例髓脂肪瘤患者的临床资料及影像学表现,观察患者年龄、性别、基础疾病;分析病灶的部位、数目、形态、大小及密度、信号及强化特点;观察大体标本及镜下结构。结果胸部髓外造血患者平均年龄43.7岁,男女性别比1.5∶1;髓脂肪瘤患者平均年龄61岁,性别比无差异。髓外造血基础疾病包括地中海贫血1例,恶性贫血1例,溶血性贫血3例;髓脂肪瘤基础疾病含糖尿病1例,慢性阻塞性肺气肿1例。5例胸部髓外造血位于双侧脊柱旁,呈多发性,扁丘状或椭圆形,病灶直径1.2~3 cm,其中3例密度不均匀,信号混杂,增强后不均匀强化;2例为均匀等密度及中等信号,轻度均匀强化。2例髓脂肪瘤位于后纵隔脊柱旁,1例单发,1例双侧对称性,类圆形,直径约4~8 cm,呈等低混合密度及混合信号,以脂肪为主,轻度不均匀强化。髓外造血大体呈红色,镜下不含或含不同比例的脂肪,造血成分多;髓脂肪瘤黄红相间,以黄色为主,脂肪成分为主,含髓系细胞。结论胸部髓外造血与髓脂肪瘤患者在发病年龄、性别、基础疾病,病灶数目、形态及大小、密度、信号、颜色、病理均有差异,可以结合临床病史及影像学特点进行正确鉴别诊断。
[Abstract]:Objective to investigate the characteristics of imaging differential diagnosis between extramedullary hematopoiesis and myelolipoma of chest. Methods the clinical data and imaging findings of 5 cases of extramedullary hematopoiesis and 2 cases of myelolipoma confirmed by pathology were retrospectively analyzed, and the age and sex of the patients were observed. The location, number, shape, size, density, signal intensity and enhancement characteristics of the lesions were analyzed, and the gross specimens and microscopic structures were observed. Results the mean age of the patients with extramedullary hematopoiesis was 43.7 years old. The average age of patients with myelolipoma is 61 years, and there is no difference in sex ratio. The basic diseases of extramedullary hematopoiesis include 1 case of thalassemia, 1 case of pernicious anemia, 3 cases of hemolytic anemia, and 1 case of diabetes mellitus. In 1 case of chronic obstructive emphysema, 5 cases of extramedullary hematopoiesis were located near the bilateral spinal column. They were multiple, flat colliculate or elliptical, the diameter of lesion was 1.2 cm, and 3 cases had heterogeneous density and mixed signal intensity. Homogeneous enhancement was found in 2 cases, and mild homogeneous enhancement in 2 cases. Mild homogeneous enhancement of myelolipoma was found in 1 case with bilateral symmetry, round shape and diameter of about 4 ~ 8 cm, showing equal low mixed density and mixed signal intensity. Extramedullary hematopoiesis is generally red, with no or different proportion of fat under microscope, and there are many hematopoietic components. Conclusion there are differences in age, sex, basic disease, number, shape and size, density, signal, color and pathology between patients with thoracic extramedullary hematopoiesis and myelolipoma. Combined with clinical history and imaging features, we can make correct differential diagnosis.
【作者单位】：上海交通大学附属胸科医院放射科;
【基金】：上海市胸科医院科技发展基金资助项目(编号:YZ13-03)
【分类号】：R445.2;R730.44

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