骨嗜酸性肉芽肿影像诊断

骨嗜酸性肉芽肿影像表现及病理分析发布时间：2022-10-14T08:01:42.893Z 来源：《医师在线》2022年14期作者：张树云[导读] 目的探讨骨嗜酸性肉芽肿影像特点及病理改变。

方法收集2018年6月-2022年6月间5例，张树云云南省红河州泸西县人民医院放射科云南省红河州 652499摘要：目的探讨骨嗜酸性肉芽肿影像特点及病理改变。

方法收集2018年6月-2022年6月间5例，分析临床影像表现及病理改变。

结果5例中男3例，女2例，都有局部间歇性疼痛，软组织肿胀。

结论骨嗜酸性肉芽肿结合临床病史及影像表现和病理分析不难做出正确诊断。

关键词：骨嗜酸性肉芽肿；影像表现；病理分析骨嗜酸性肉芽肿是以骨破坏及有大单核细胞、嗜酸细胞集聚为特征。

最多见于小儿及青年，约2/3患者发病于20岁前，男性较女性发病率高。

骨嗜酸性肉芽肿易见于扁平骨，尤以头颅及肋骨为著，还可发生于脊椎、股骨、下颌骨和肱骨，而手及足骨则不受累。

1材料与方法1.1一般资料 2018-2022年我院经手术病理证实骨嗜酸性肉芽肿共6例有，其中男性4例，女2例，年龄5月-12岁，平均7岁。

部位：颅骨4例，长骨1例，骨盆1例，多发者2例。

经手术后病理确诊5例，经穿刺病理确诊1例。

有局部疼痛、软组织肿胀及骨质破坏性改变4例，仅有骨质破坏1例，无症状者1例。

1.2头颅X线片使用岛津DR机，上缘包括顶骨，下缘包下颌骨，患儿贴近平板探测器，球管与患儿的距离1.2m。

1.3 CT片使用128排螺旋CT,层厚1.5mm，螺距1.3，重建间隔0.7mm,5例增强的扫描。

1.4病理标本HE染色，电子光镜观察，免疫组化采用Envision两步法标记。

2 结果DR、CT均表现为骨肿块、骨质破坏、骨膜反应，肿瘤样外观范围比较局限，以边界清楚的骨破坏透亮区为主要表现，不像恶性骨肿瘤呈现边界不规则，浸润性分布的特点。

由于骨具有自我修复功能，被破坏的骨质重新生长，影像上出现亮度较高的硬化外观。

儿童颅骨嗜酸性肉芽肿的影像学诊断叶圣利;林晓荷;罗莉莉;许思恩;何家维【期刊名称】《温州医学院学报》【年(卷),期】2014(000)010【摘要】Objective: To investigate the image manifestation and improve the ability of diagnosis of skull eosinophilic granuloma in chidlren.Methods: Imaging data of skull eosinoplilic granuloma in children-retrospec-tive analysis of 20 cases by X-ray, CT and MRI scan, included: 2 cases of X-ray, 20 cases of CT scan, 4 cases of MRI scan (including 2 cases of enhancement scanning).Results: Out of 20 cases, single lesion was found in 16 cases, and multiple lesions were found in 4 cases. There were totally 26 lesions in all 20 patients, temporal bone (n=13), frontal bone (n=7), occipital bone (n=4), parietal bone (n=2) were respectively being involved. The X-ray ifndings of 2 cases were clear, sharp edge of the circular hole shaped bone destruction. The CT scanning found 26 lesions, including 7 cases of osteolytic destruction, 19 cases of punched-out like bone defect, 21 cases of soft tissue mass. The MRI scanning revealed 4 cases of soft tissue mass adjacent to the osteodestructions. Compared with gray matter of the brain, MR showed isosignal intensity on T1WI and T2WI after intravenous injection of Gd-DTPA, the lesions showed enhanced remarkably.Conclusion: The CT and MR manifestations of children skull EG have certain characteristics. Combination of medical record may improvethe diagnostic accuracy in the majority of cases. The MRI can accurately show the location, shape and extent of skull eosinophilic granuloma in children which is valuable in differential diagnosis of various causes.%目的：探讨儿童颅骨嗜酸性肉芽肿（EG）的影像学表现，以提高临床对此病的诊断水平。