原发性骨骼淋巴瘤的影像学诊断

龚永进; 周建军; 周康荣

中国临床医学影像杂志 ›› 2006, Vol. 17 ›› Issue (5) : 275-278.

论著

原发性骨骼淋巴瘤的影像学诊断

龚永进1,周建军2,周康荣2

作者信息 +

The imaging diagnosis of primary lymphoma of bone

GONG Yong-jin1, ZHOU Jian-jun2, ZHOU Kang-rong2

Author information +

文章历史 +

摘要

目的:分析13例骨骼淋巴瘤的影像学特征以探讨其影像学的诊断价值。材料和方法:13例经手术病理证实的骨骼淋巴瘤病例,术前均经平片检查,其中CT检查10例,MR检查9例。结果:4例何杰金淋巴瘤和9例非何杰金淋巴瘤分别累及脊柱6例,长管状骨5例,骨盆2例,病变主要累及脊柱的椎体和长管状骨的骨干,骨质改变为溶骨型9例(69%)和混合型4例(31%),骨质破坏以浸润性虫噬状骨质破坏为主;骨皮质破坏11例,但皮质破坏的程度总是很轻微;骨膜成骨3例(23%),软组织肿块形成7例(54%)。软组织肿块CT表现为低密度或等密度,境界清楚;骨骼MRI T1WI低信号9例,T2WI显示为略低信号2例,等信号2例,高信号5例;软组织肿块的MR信号变化少,T1WI略低于肌肉,T2WI总是略高于肌肉,MR动态增强扫描为轻~中等程度强化。结论:骨骼淋巴瘤影像学特征:①明显的浸润性虫噬状骨质破坏,而骨皮质破坏轻微,骨膜反应少见;②软组织肿块T2WI信号略高,且信号相对均匀。平片、CT和MRI等影像学检查可以作出诊断。

Abstract

Objective: Exploring the imaging features of lymphoma of bone and evaluating their clinical value. Materials and Methods: Thirteen patients of lymphoma confirmed by surgery and pathology underwent conventional radiography, in whom 10 underwent CT scan, and 9 underwent MR imaging. The acquired images were reviewed and analysed retrospectively and correlated with surgical and pathological results. Results: Nine non-Hodgkin’s and 4 Hodgkin’s lymphoma affected spine(46%), acetabulum(15%) and long bones(39%) respectively. Common locations were the vertebral body of spine and diaphysis of a major long bone. Common appearances were a lytic(69%) and mixed-density(31%) lesion with most cases showing an infiltrative or moth-eaten pattern. Cortical destruction was seen in 11 parients(85%) but usually without extensive cortical destruction. Periosteal reaction was seen in 3 patients(23%). Soft-tissue masses were present in 7 patients(54%). Lymphomas are hypo-dense or isodense to muscle on CT with circumscribed or distinct margins. Lymphomas appear low in signal intensity on T1-weighted images and low to high in signal intensity on T2-weighted images. Soft-tissue masses appear low in signal intensity on T1-weighted images and slightly high in signal intensity on T2-weighted images without much variable and with usually mild, enhancement following Gadolinium-DTPA(Gd-DTPA) contrast material injection. Conclusion: Lymphoma of bone has an infiltrative or moth-eaten pattern lytic bone destruction associated with soft-tissue mass. Radiography, CT and MR imaging can suggest the diagnosis, particularly when slightly high in signal intensity on T2-weighted images of a soft-tissue mass without extensive cortical destruction.

导出引用

龚永进;周建军;周康荣. 原发性骨骼淋巴瘤的影像学诊断[J]. 中国临床医学影像杂志. 2006, 17(5): 275-278

GONG Yong-jin;ZHOU Jian-jun;ZHOU Kang-rong. The imaging diagnosis of primary lymphoma of bone[J]. Journal of China Clinic Medical Imaging. 2006, 17(5): 275-278

中图分类号： R738.1 R814.42 R445.2