摘要
目的探讨脊柱外骨孤立性浆细胞瘤(SPB)的影像学特点,提高影像诊断水平。方法搜集经手术病理证实的22例脊柱外SPB患者的术前影像资料,回顾性分析其X线、CT、MRI表现以及误诊原因。结果 22例脊柱外SPB X线及CT表现为膨胀性、溶骨性骨质破坏,边界较清,边缘见弧形压迹,骨皮质变薄、中断,无硬化边或钙化;11例病灶可见骨嵴从边缘向中心延伸;1例见不规则骨膜反应,其余病灶未见明显骨膜反应。MRI显示14例病灶呈稍短T1、稍长T2信号,增强明显强化;肿瘤局部突破骨皮质向外侵犯,呈"伪足征";2例病灶周围形成软组织肿块;无瘤周骨髓水肿。14例术前影像学检查报告误诊,其中误诊为淋巴瘤5例,骨巨细胞瘤4例,纤维肉瘤2例,转移瘤2例,脊索瘤1例。结论脊柱外SPB的影像表现有一定特征,其MRI信号特点在SPB的诊断及鉴别诊断中有重要价值,但仍需与骨淋巴瘤、单发转移瘤相鉴别。
Objective To assess the imaging features of solitary extra-spinal plasmacytoma. Methods The imaging studies of 22 patients with histologically confirmed solitary extra -spinal plasmacytomas were retrospectively analyzed. .Results On radiographs and CT , the lesions were expansile and lytic with well-defined margins , cortical thinning or erosion , no calcification or sclerotic rim..Residual bone trabecula was present in 11 patients whereas irregular periosteal reaction was found in only 1 patient. On MRI,.14 tumors were slightly T1 and T2 hyperintense relative to muscle or brain with homogenous enhancement and no necrosis. The lesions showed an infiltrative growth pattern. Associated soft-tissue mass was noted in 2 and peritumoral marrow edema in none. 63.6% （14/22） of the tumors were misdiagnosed as lymphomas （5）, giant cell tumors （4）, fibrosarcomas （2）, metastases （2） and chordoma （1）. Conclusion Most of the solitary extraspinal plasmacytomas have some specific imaging features , especially on MRI. However, differentiation from primary and secondary bone tumors may be difficult.
出处
《影像诊断与介入放射学》
2015年第1期64-67,共4页
Diagnostic Imaging & Interventional Radiology
关键词
骨肿瘤
浆细胞瘤
体层摄影术
X
线计算机
磁共振成像
误诊
Bone neoplasms
Plasmacytoma
Tomography,X-ray computed
Magnetic resonance imaging
Misdiagnosis
