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目的探讨长骨血管瘤的X线及MRI表现及病理基础,旨在提高对其征象及鉴别诊断的认识。方法回顾性分析经病理证实的10例(男4例,女6例)长骨血管瘤患者影像资料,其中股骨4例,胫骨4例,腓骨1例,尺骨1例。所有患者均行X线平片、MRI平扫及增强扫描。结果 X线表现为多囊状骨质破坏7例,网格或蜂窝样改变2例,局灶性皮质增生改变1例。MRI上髓内型呈多囊状改变6例,T1WI呈等低信号,T2WI呈高信号,在T1WI及T2WI上病灶内及边缘见线状或纤维条索状低信号分隔;网格或蜂窝状改变2例,在T1WI及T2WI上病灶内见网格或蜂窝状低信号。骨膜型1例,骨膜下见类梭形T1WI等信号、T2WI混杂高信号;骨皮质内型1例,骨皮质局部增厚、隆起,T1WI呈等信号,T2WI呈高信号,邻近髓腔变窄。增强后均呈不均匀强化。结论长骨血管瘤X线及MRI表现多样,与病理类型有关。X线对诊断具有一定价值。MRI有助于反映病变组织成分、病变范围,对治疗方案的选择具有指导作用。
Objective To investigate the X-ray and MRI findings of long bone hemangiomas and their pathological basis in order to improve their understanding of the signs and differential diagnosis. Methods We retrospectively analyzed the imaging data of 10 patients with long bone hemangiomas confirmed by pathology, including 4 femur, 4 tibia, 1 fibula and 1 ulnar. All patients underwent plain radiography, MRI plain scan and enhanced scan. Results X-ray showed polycystic bone destruction in 7 cases, grid or honeycomb-like changes in 2 cases, focal cortical hyperplasia in 1 case. MRI showed multiple intracapsular changes in 6 cases, T1WI showed low signal, T2WI showed high signal, in T1WI and T2WI lesions and the edge of linear or fibrous cord-like low signal separation; grid or honeycomb Change in 2 cases, in the T1WI and T2WI lesions see the grid or cellular low signal. One case of periosteum, subperiosteal see spindle-like T1WI and other signals, T2WI mixed high signal; cortical endometriosis in 1 case, cortical local thickening, uplift, T1WI was equal signal, T2WI was high signal, near the medullary cavity narrowed . After the enhancement were uneven reinforcement. Conclusion X-ray and MRI findings of long bone hemangiomas are diverse and related to pathological types. X-ray diagnosis has some value. MRI helps to reflect the lesion tissue components, the scope of the disease, the choice of treatment options have a guiding role.