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目的探讨骨原发性非霍奇金淋巴瘤影像表现及诊断价值。方法回顾性分析16例经手术病理证实的骨原发性非霍奇金淋巴瘤。16例患者均行相应部位X线检查,8例行CT检查,4例行MRI检查。结果16例中病变位于肋骨、髂骨、胫骨、跟骨各1例,肱骨2例,股骨5例,脊椎5例,4例合并病理性骨折。X线及CT表现为浸润型5例,溶骨型6例,囊状膨胀型1例,混合型4例。MRI检查4例均为椎体淋巴瘤,表现为T1WI呈等或稍低信号,T2WI呈等或稍高信号,增强扫描呈轻至中度强化。结论长骨及脊椎为本病好发部位,影像表现以浸润型和溶骨型多见,骨质破坏范围相对较小而软组织肿块较大为特点,CT对本病的骨质改变和骨膜反应等观察优于X线。MRI对早期骨质改变和软组织侵犯的显示优于X线和CT。
Objective To investigate the imaging manifestations and diagnostic value of primary non-Hodgkin’s lymphoma. Methods Retrospective analysis of 16 cases of bone non-Hodgkin’s lymphoma confirmed by surgery and pathology. 16 patients underwent X-ray examination of the corresponding site, 8 patients underwent CT examination, 4 patients underwent MRI examination. Results The lesions were located in 1 case of rib, ilium, tibia and calcaneus in 16 cases, 2 cases of humerus, 5 cases of femur, 5 cases of spine and 4 cases of pathological fracture. X-ray and CT showed invasive infiltration in 5 cases, osteolytic in 6 cases, cystic swelling in 1 case, mixed-type in 4 cases. MRI examination of 4 cases were vertebral lymphoma, T1WI was showed equal or slightly lower signal, T2WI was equal or slightly higher signal, enhanced scan was mild to moderate enhancement. Conclusion The long bones and spine are the predilection sites of the disease. The images are characterized by infiltrative and osteolytic appearances, relatively small bone destruction and large soft tissue mass. The bone changes and periosteal reactions of CT Observation is superior to X-ray. MRI is superior to X-ray and CT in displaying early bone changes and soft tissue invasion.