兒童肩胛骨腫瘤的影像學(xué)診斷與鑒別
本文選題:兒童 + 肩胛骨; 參考:《臨床放射學(xué)雜志》2015年12期
【摘要】:目的探討兒童肩胛骨腫瘤的影像學(xué)表現(xiàn)。方法搜集21例經(jīng)穿刺活檢或手術(shù)病理證實(shí)的肩胛骨腫瘤患者的X線(n=21)、CT(n=14)和CT增強(qiáng)(n=1)檢查資料,分析其病變類型、部位、發(fā)病特點(diǎn)和影像表現(xiàn)。結(jié)果良性腫瘤12例(骨軟骨瘤11例、血管瘤1例),病變均位于S_1區(qū);中間型腫瘤8例(嗜酸性肉芽腫6例,動(dòng)脈瘤樣骨囊腫2例),5例累及S_2區(qū)。惡性腫瘤1例(尤文肉瘤),同時(shí)累及S_1、S_2區(qū)。骨軟骨瘤多表現(xiàn)寬或窄基底骨性凸起;血管瘤表現(xiàn)為溶骨性骨質(zhì)破壞,邊緣不清,易誤診為惡性腫瘤;嗜酸性肉芽腫呈溶骨性骨質(zhì)破壞,邊界清晰可伴層狀骨膜反應(yīng);動(dòng)脈瘤樣骨囊腫呈膨脹性骨質(zhì)破壞,可見典型"液-液平面"征象;尤文肉瘤表現(xiàn)為蟲蝕樣骨質(zhì)破壞、放射狀骨膜反應(yīng)及明顯軟組織腫塊,具有特征性。結(jié)論兒童肩胛骨腫瘤以良性及中間型腫瘤多見,骨軟骨瘤均位于S_1區(qū),以骨性突起多見,中間型腫瘤多位于S_2區(qū),骨質(zhì)破壞邊界清楚,伴硬化邊;而惡性腫瘤破壞范圍較廣,常同時(shí)累及S_1及S_2區(qū),邊界模糊,且骨膜反應(yīng)明顯。
[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.
【作者單位】: 遵義醫(yī)學(xué)院附屬醫(yī)院影像科貴州省醫(yī)學(xué)影像中心;
【分類號(hào)】:R738;R730.44
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