摘要
目的分析骨孤立性浆细胞瘤(SPB)影像学表现,提高对其认识和诊断水平。方法回顾性分析四家医院7例经手术和病理证实的SPB患者的临床表现、X线平片、CT及MRI资料,并进行影像学分析。结果 (1)病灶位于长骨5例,骨盆1例,脊椎1例。(2)X线及CT7例均表现为单发溶骨性膨胀性骨质破坏,骨内膜侵蚀,边界清楚,边缘无硬化,无骨膜反应。6例骨皮质变薄。2例骨皮质侵蚀呈虫蚀状或锯齿状。2例见残存骨嵴。2例长骨病变呈皂泡样改变。2例发生病理骨折。(3)与肌肉相比,病变MRI信号平扫T1WI呈等信号或稍高信号,T2WI呈稍高信号,未见骨髓水肿,病灶侵及周围软组织T2WI见高信号带,脊椎病变突向椎管,增强扫描明显均匀强化。结论 SPB的影像表现具有一定的特征性,长骨SPB X线结合MRI,脊椎与骨盆SPB X线、CT和MRI综合评价有助于提高SPB的诊断准确性。但仍需与骨转移瘤、骨巨细胞瘤及淋巴瘤等相鉴别。
Objective To analyze the imaging findings of solitary plasma cell tumor of bone （SPB）, and to improve the recognition and diagnosis of it. Method The clinical manifestation, X-ray, CT and MRI data of 7 cases of SPB proved by surgery and pathology in four hospitals were analyzed retrospectively and analyzed by imaging. Results （1）The lesions were located in 5 cases of long bones, 1 case in pelvis and lcase in spine. （2）X-ray and CT7 showed solitary osteolytic swelling bone destruction,bone erosion, clear border, marginal sclerosis and no periosteal reaction. In 6 cases, the cortical bone became thinner. 2 cases showed bony erosion or serrated shape. 2 cases showed residual bone ridge. 2 cases of long bone lesions showed soap bubble change. 2 cases had pathological fracture. （3）Compared with muscle lesions, MRI signal scan showed T1WI signal or slightly high signal, T2WI showed slightly higher signal, no bone marrow edema. The lesion invaded the surrounding soft tissue, T2WI showed high signal band, the verte- bral lesion protruded into the spinal canal, and the enhanced scan was obviously homogeneous. Conclusion SPB imaging has certain characteristics. SPB long bone X-ray combined with MRI, spine and pelvis X-ray SPB, CT and MRI comprehensive evaluation are helpful to improve the diagnostic accuracy of SPB. But it still needs identification with bone metastasis, bone giant cell tumor and lym- phoma.
出处
《四川医学》
CAS
2017年第7期830-833,共4页
Sichuan Medical Journal
关键词
孤立性浆细胞瘤
骨
体层摄影术
X线计算机
磁共振成像
solitary plasma cell tumor
bone
tomography
x-ray computed
magnetic resonance imaging
