肩胛骨嗜酸性肉芽肿的影像学表现

发布时间：2019-02-15 10:10

【摘要】：目的分析肩胛骨嗜酸性肉芽肿的影像学表现,探讨其临床特点和鉴别诊断价值。方法分析8例肩胛骨嗜酸性肉芽肿的临床和X线、CT及MRI影像学资料。结果 8例患者中,所有病灶均累及关节盂部。X线平片上所有病灶表现为溶骨性骨质破坏,局部骨皮质变薄。7例行CT检查者中,4例病灶骨质破坏区可见残存细小骨碎片。6例病灶可见周围骨皮质不规则破坏中断,其中3例可见软组织肿块形成,1例见骨膜反应;1例骨皮质规则完整。1例全肩胛骨弥漫性病灶呈囊状膨胀性骨质破坏,周围见多发结节及团块状软组织肿块,同侧腋窝见多发肿大淋巴结。2例行MRI检查者病灶表现为等T_1、长T_2信号,其中1例骨皮质中断破坏,周围软组织见大片稍长T_1、长T_2信号水肿灶,T_2WI及脂肪抑制序列可见病变边缘环绕线状低信号影。结论儿童及青少年肩胛骨尤其关节盂出现溶骨性骨质破坏,相邻骨皮质变薄或破坏中断,可伴有软组织肿块,影像学改变明显而临床症状轻微,应考虑到嗜酸性肉芽肿的可能性。
[Abstract]:Objective to analyze the imaging features of scapular eosinophilic granuloma and to explore its clinical features and differential diagnosis. Methods 8 cases of scapular eosinophilic granuloma were analyzed by X-ray, CT and MRI. Results among the 8 patients, all lesions involved the glenoid of the joint. All the lesions on the X-ray plain film showed osteolytic bone destruction, and the local bone cortex became thinner. Small fragments of bone were found in 4 cases, irregular disruption of the surrounding bone cortex was found in 6 cases, soft tissue mass formation was found in 3 cases and periosteal reaction was found in 1 case. The bone cortex of 1 case was complete. 1 case of diffuse lesion of scapular bone presented as cystic expansive bone destruction, and multiple nodule and mass of soft tissue mass were seen around it. Multiple enlarged lymph nodes were found in the ipsilateral axilla. In 2 patients with MRI, the lesions presented as iso-T _ 1, long T _ 2 signal, one of which was cortical disruption, the surrounding soft tissue was slightly longer T _ 1, and the long T _ 2 signal edema was found in the surrounding soft tissue. T_2WI and fat suppression sequences showed that the lesions were surrounded by linear hypointensity. Conclusion Osteolytic bone destruction occurs in the scapular bones of children and adolescents especially in the articular glenoid. The adjacent cortical bone is thinned or broken and may be accompanied by soft tissue masses. The imaging changes are obvious and the clinical symptoms are mild. The possibility of eosinophilic granuloma should be considered.
【作者单位】：福建医科大学附属协和医院放射科;
【分类号】：R681;R816.8;R445.2

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