动脉瘤样骨囊肿的影像学诊断

目的：探讨动脉瘤样骨囊肿（ABC）的影像学特点。资料与方法：回顾性分析23例经手术病理证实的ABC的影像学表现，23例均摄X线平片和CT平扫。4例行MRI检查。结果：23例ABC发生于长骨18例，骨盆5例。ABC平片表现常为偏心性膨胀性骨破坏；CT平扫可见膨胀的骨壳内缘呈清晰弧形压迹，其中骨壳完整12例，断缺11例。病灶密度不均，19例可见蜂房样低密度影或液－液平面，15例出现软组织肿块；4例MRI主要表现为T1WI呈等低信号，T2WI呈大小不一高信号囊腔或液－液平面，3例增强扫描，2例无明显强化，1例轻度强化，囊间隔在T1WI、T2WI及增强后均为低信号。结论：X线平片简便经济，但对内部结构的显示有一定限度，CT和MR对内部结构及软组织的显示明显优于前者，对ABC具有很高的诊断价值。     

实性动脉瘤样骨囊肿的影像学表现

目的 探讨实性动脉瘤样骨囊肿的影像学表现,提高本病的鉴别诊断能力。资料与方法 回顾性分析2007年1月—2019年1月空军军医大学西京医院经术后病理证实的5例实性动脉瘤样骨囊肿的X线、CT、MRI资料,分析病灶所在母骨位置、病灶大小形态、边缘、肿瘤基质和周围软组织改变等影像学征象。结果 5例均为女性,病灶发生于胫骨2例、股骨1例、寰椎椎弓1例、髋臼周围1例,均偏心性位于母骨。病灶大小4.0～17.0 cm,均为大片状地图样、溶骨性破坏,膨胀性较轻。病灶边界清晰3例、模糊2例,有窄且长短不等的硬化缘。所有病灶骨皮质变薄、壳样改变,局部断裂、筛孔状改变或大段缺失。1例周围有软组织肿块。所有病变均无骨膜反应。2例病灶周围广泛水肿。CT表现：2例病灶内部呈等或略低于肌肉密度,无基质矿化。MRI表现：2例病灶内部T1WI信号略高于肌肉,T2WI呈均匀高信号,且有点状更高信号。所有病例均无病理性骨折。结论 实性动脉瘤样骨囊肿青年女性好发。病灶呈轻度膨胀性、溶骨性改变,有窄硬化缘,CT呈均匀等低密度,MRI呈混杂信号,可突破骨皮质形成软组织肿块,邻近骨髓与软组织明显水肿。     

肋骨动脉瘤样骨囊肿1例

男,28岁.左侧胸部不适数年,近3月局限性疼痛,肿胀、压痛明显加重,病情发展较快.体检:左侧胸部第10后肋处局部隆起,可扪及包块,质硬,肋骨受累.肺部听诊,未闻及干湿啰音.胸部X线检查:左侧第10后肋沿骨的长轴呈囊状膨胀,囊内有淡而粗的皂泡状结构阴影.骨皮质变薄,边缘清晰锐利并伴有硬化,X线诊断意见:左侧第10后肋骨动脉瘤样骨囊肿.     

动脉瘤样骨囊肿的影像学表现与诊断价值分析

目的 分析动脉瘤样骨囊肿影像学表现及X线、CT、MRI分别在动脉瘤样骨囊肿诊断中的价值,提高对本病的认识.方法 回顾性分析经病理学证实的22例动脉瘤样骨囊肿的影像学表现,全部病例均行X线检查,其中5例行CT检查,10例行MR检查.结果 X线检查均表现为囊性、膨胀性骨质破坏伴骨包壳形成,15例内部见粗细不匀骨间隔.CT检查能显示病灶内部的细小骨嵴、骨包壳中断情况及囊性低密度区,其中2例见液-液平面.MR扫描T1WI 4例显示液-液平面,T2WI 7例显示液-液平面,囊间隔与囊壁厚薄不等,增强扫描强化明显.结论 X线平片呈膨胀性溶骨改变,CT和MRI出现囊腔、液-液平面、强化明显的囊壁及囊间隔征象是诊断的重要依据.     

颅骨动脉瘤样骨囊肿的影像学表现

目的：探讨颅骨动脉瘤样骨囊肿的影像学表现，提高对颅骨动脉瘤样骨囊肿的认识。资料与方法：搜集经手术病理证实的4例颅骨动脉瘤样骨囊肿，全部病例均作了CT平扫与MRI检查，其中1例摄有颅骨平片，1例MR／增强扫描，1例DSA检查。结果：4例颅骨动脉瘤样骨囊肿中，1例位于左蝶骨嵴和左眶骨处，2例位于左颞骨。1例位于右额骨。CT上均表现为不同程度的膨胀性吹气球样溶骨破坏区，密度不均匀；MRI示有出血、囊变及液面，T1WI和R2WI上呈混杂信号，1例增强后示肿瘤实质和邻近脑膜强化；血管造影示血管有推移改变。结论：颅骨动脉瘤样骨囊肿的影像学表现有一定的特征性，CT与MRI相结合能提示诊断，并有助于评价周围结构。     

动脉瘤样骨囊肿的影像学分析

目的 分析动脉瘤样骨囊肿(ABC)的影像学特点,以提高对本病的认识.方法 回顾性分析19例经手术病理证实的ABC的影像学表现.19例均行X线平片检查,18例行螺旋CT检查,6例行MR检查.结果 原发性ABC共11例,继发性ABC 8例.发生于长管状骨的ABC 12例,脊柱3例,短骨及扁骨4例.17例病变呈膨胀性骨质破坏,15例病变边缘可见骨嵴,14例边缘可见硬化,12例合并病理性骨折,18例病变内密度和(或)信号显示不均匀,9例病变内可见分隔,3例可见典型的液-液平面,4例病变周围可见软组织异常改变,其中3例软组织肿胀,1例软组织肿块.结论 不同发病部位动脉瘤样骨囊肿影像表现有所不同,继发性ABC影像表现具有一定的原发病灶的特征.     

原发性及继发性动脉瘤样骨囊肿的影像学诊断

目的：分析原发性及继发性动脉瘤样骨囊肿（ABC）的影像学表现,评价其影像学诊断价值。材料和方法：回顾性分析经手术或活检证实的动脉瘤样骨囊肿176例,其中原发性动脉瘤样骨囊肿111例,继发性动脉瘤样骨囊肿65例。完整影像学资料共42例,均行X线检查,其中30例行CT检查,15例行MRI检查,9例同时行CT及MRI检查。结果：42例动脉瘤样骨囊肿平片上根据病变部位分偏心型22例、髓内型18例、骨旁型2例,大多数表现为偏心型膨胀性骨破坏;CT扫描可见25例不同程度骨膨胀、骨皮质内缘的分房状压迹和骨嵴影,皮质破坏断缺7例,15例见骨包壳,3例见液-液平面;15例MRI扫描表现为分叶状肿块,9例MRI表现为T1WI低、T2WI高信号囊腔,6例表现为混杂信号,囊间隔均为T1WI、T2WI低信号,6例行MRI增强扫描,均见间隔强化,5例见液-液平面。结论：原发性及继发性动脉瘤样骨囊肿具有一定的影像学特征,X线、CT及MRI三者结合能明显提高诊断正确率。     

动脉瘤样骨囊肿的影像学诊断及误诊分析

目的:通过对动脉瘤样骨囊肿(ABC)影像学诊断及误诊的分析,进一步探讨ABC的影像学特点。方法:结合病理特点回顾性分析22例经手术病理证实的正确诊断及误诊的ABC的影像学表现,22例均摄X线平片,19例行CT平扫,15例行MRI。结果:22例ABC发生于长骨17例,脊柱3例,骨盆2例。ABC平片表现常为偏心性膨胀性囊性改变;CT平扫可见膨胀的骨壳内缘呈清晰弧形压迹,其中骨壳完整18例,21例可见蜂房样低密度影,1例出现液-液平面,2例软组织肿块;15例MRI主要表现为T1WI呈等低信号,T2WI呈大小不一高信号囊腔或液-液平面,囊间隔在T1WI、T2WI均为低信号。误诊4例,其中发病部位长骨2例,脊柱和骨盆各1例。结论:正确认识ABC发病机理及病理特点的基础上,结合X线、CT和MRI的特征性影像学表现,进行综合分析是正确诊断ABC,避免误诊的关键所在。     

动脉瘤样骨囊肿-CT和MR图像上的再认识

目的：评价CT和MRI图像上液-液平面征象对诊断动脉瘤样骨囊肿(ABC)的价值．材料和方法：回展性分析11例经病理证实的ABC的平片，CT和MR表现．并用双盲法测试单纯平片和综合影像分析(平片、CT、MRI)的诊断符合率。结果：1.单纯平片诊断符合率低于综合影像诊断；2．CT和MR有助于显示病变的范围，与周圈组织的关系和病灶内的特征；3．在CT和MRI上ABC可见到液-液平面征。结论：CT和MRI上的液-液平面征是ABC较特征性的征象．综合性影像检查能提高ABC的诊断准确率．     

额骨纤维结构不良合并动脉瘤样骨囊肿1例

<正>患者 男,54岁。因“发现额部快速增大、有搏动感的肿块半月余”就诊。查体：前额部隆起,表面光滑,大小约5.5 cm×4.5 cm×3.0 cm, 边界清楚,触之皮温偏高、有弥散搏动感,皮肤颜色偏红,无破损、无压痛、瘙痒。     

Imaging features of subperiosteal aneurysmal bone cyst

PURPOSE: To analyze the imaging features of subperiosteal aneurysmal bone cyst. MATERIAL AND METHODS: The imaging material of 6 patients with biopsy-proved subperiosteal aneurysmal bone cyst was reviewed. Evaluation included patient demographics, lesion location and size, radiographic features, and intrinsic characteristics on CT and MR images. Review of histologic specimens was carried out by an experienced musculoskeletal pathologist. RESULTS: All lesions were located at the surface of long tubular bones (femur 3, tibia 2, humerus 1): 3 involved the diaphysis, 2 the dia/metaphysis, and 1 exclusively the metaphysis. Lesion size ranged from 2.5 to 6 cm in maximum diameter. Radiographs and CT images always showed a superficial bone defect, which on radiographs demonstrated irregular margins in 4 cases. All lesions caused an interrupted periosteal reaction (shell 3, trabeculated shell 1, Codman angle 2). MR images always showed a multicystic appearance with a hypointense rim, contrast-enhancing cyst walls, and fluid levels. Edema of adjacent soft tissues was present in all cases. CONCLUSION: Aneurysmal bone cyst in a subperiosteal location can demonstrate an aggressive radiographic appearance. MR imaging appears to be most valuable in the differential diagnosis, since it can demonstrate typical morphological features of the underlying process.     

骨纤维结构不良继发动脉瘤样骨囊肿影像诊断

目的探讨CT与MRI对骨纤维结构不良继发动脉瘤样骨囊肿的诊断价值。方法对12例病理证实的骨纤维结构不良继发动脉瘤样骨囊肿CT及MRI资料进行回顾性分析。其中6例行CT检查,4例行MRI检查,另有2例分别行CT及MRI检查。结果单骨型11例,其中股骨5例,肱骨4例,腓骨1例及桡骨1例;多骨型1例,同时累及髋臼、坐骨支及股骨。在CT上可见病变不同程度膨胀,5例成单囊状或多囊状改变,3例成囊实性改变,实性部分呈磨玻璃样改变。在MRI上,6例均呈囊实性改变,实性部分在T1WI上呈均匀或不均匀低、等信号,在T2WI上呈均匀或不均匀低、等或高信号,增强扫描后呈轻或中度强化,其囊性部分呈T1WI低信号及T2WI高信号改变,骨皮质变薄,3例囊内见分隔,1例见液-液平面,增强扫描后仅有囊壁及囊内分隔强化。结论 MRI对骨纤维结构不良继发动脉瘤样骨囊肿诊断比CT有优势,但作出准确的术前诊断仍需结合X线或CT。     

Juxtaepiphyseal aneurysmal bone cyst

Nine cases of aneurysmal bone cyst arising in juxtaepiphyseal locations with gross invasion of the adjacent growth plate are reported. In five of these patients an abnormality of growth, due to premature fusion of the affected growth plate, ultimately developed. Treatment of these lesions should attempt to avoid this complication, which appears to be more common than has been appeaciated in the past. These nine cases represent 23% of 39 cases of aneurysmal bone cyst occurring in a long bone adjacent to an open epiphyseal plate. This series was extrapolated from a total of 198 cases of aneurysmal bone cyst in the files of the Istituto Ortopedico Rizzoli, Bologna, Italy.     

骨巨细胞瘤合并动脉瘤样骨囊肿的影像学表现分析

目的：探讨骨巨细胞瘤（GCT）合并动脉瘤样骨囊肿（ABC）的影像学表现及鉴别特点,以提高其诊断水平。方法：回顾性分析经手术、病理证实的14例GCT合并ABC的影像学表现。所有患者均行X线检查,11例行CT检查,12例行MRI扫描,2例行全身骨显像。对其影像学表现和病理结果进行对照。结果：14例中,病灶位于股骨6例,胫骨3例,尺骨3例,腓骨1例,桡骨1例。X线及CT表现为膨胀性骨质破坏,病灶密度不均匀,皮质变薄或中断。肿瘤实质区T₁WI呈等或低信号、T₂WI呈以高信号为主的混杂信号,病灶内多伴囊变和液-液平面,病灶周围骨质水肿,增强扫描病灶大部分呈明显强化。全身骨现象主要表现为病变部位片状放射性核素浓聚,显影不均匀。结论：GCT合并ABC的CT、MRI表现具有一定特征,结合X线、全身骨显像检查,有助于提高该病的术前诊断准确率,为临床治疗方案的制订提供帮助。     

骨巨细胞瘤继发动脉瘤样骨囊肿的影像诊断

目的提高骨巨细胞瘤（GCT）继发动脉瘤样骨囊肿（ABC）的认识和影像诊断水平。方法搜集经手术病理证实的12例GCT继发ABC的X线、CT、MRI和病理学资料，分析和总结其影像征象。结果12例中6例病变发生于长管状骨，6例发生于盆骨。12例病变X线均表现为囊状膨胀性溶骨性骨破坏，10例呈偏心性破坏，2例为中心性破坏；4例病灶内出现骨性分隔，6例骨皮质中断，4例出现软组织肿块，有明显硬化边者2例。10例行MR平扫和增强检查，均呈多囊的囊实性膨胀性肿块，8例为边缘性实性结节，2例为实性基础上的广泛囊变，全部患者均可见多个液一液平面，7例出现软组织肿块；1例肿块内可见局灶性含铁血黄素沉着。8例行螺旋cT平扫、增强、CT血管成像（CTA）和三维（3D）多平面重组（MPR），病变显示为囊实性肿块，骨皮质破裂并形成软组织肿块5例，6例肿块内出现液．液平面，全部肿块实质性部分和囊壁明显强化，囊性部分不强化，3例肿块内可见增粗迂曲的供血动脉，未发现动静脉畸形。12例手术所见和术后病理显示肿块均由多发含血的囊腔和实性部分组成，病理诊断结果均为GCT伴发ABC，其中Ⅱ级GCTl0例，Ⅲ级2例。结论GCT伴发ABC并不少见，充分理解其病理组织学基础，并选择恰当的影像检查方法（X线＋MRI或X线＋CT）对其正确诊断非常重要。     

Soft tissue aneurysmal bone cyst

A soft tissue aneurysmal bone cyst located in the right gluteus medius of a 21-year-old man is reported. On conventional radiography, the lesion demonstrated a spherically trabeculated mass with a calcific rim. On CT scan, it showed a well-organized peripheral calcification resembling a myositis ossificans. On MRI, it presented as a multilocular, cystic lesion with fluid-fluid levels. The lesion had no solid components except for intralesional septa. Although findings on imaging and histology were identical to those described in classical aneurysmal bone cyst, diagnosis was delayed because of lack of knowledge of this entity and its resemblance to the more familiar post-traumatic heterotopic ossification (myositis ossificans).     

Giant-cell tumor of bone and aneurysmal bone cyst

A correlated histologic and radiographic study of nine giant-cell tumors, six aneurysmal bone cysts, and one combined lesion is presented. Clinical findings and plain radiographic appearances were found to overlap. Angiographically, the giant-cell tumors were richly vascularized, with a marked intratumoral contrast uptake, occasional irregular tumor vessles, a prominent peritumoral arterial net-work, and early draining veins. Microscopic examination revealed fine, capillary-like and somewhat larger, angulated, sinusoid vessels, and occasional small, bloodfilled cysts within the tumor. Conspicuous arteries, veins, and capillaries surrounded the tumor. The aneurysmal bone cysts at angiography were predominantly avascular in the interior, surrounded by a thin hyperemic zone in the peritumoral tissue, with sometimes early filling of veins. Microscopically, the aneurysmal bone cysts showed large, anastomosing, bloodfilled vascular channels, and a moderate number of capillaries within the solid, fibrous areas and the granulation tissue. It is concluded that angiography, particularly with a subtraction technique, may be a valuable diagnostic method in the pre-operative differentiation of giant-cell tumors from aneurysmal bone cysts.     

Therapeutic embolization of aneurysmal bone cyst

Results of therapeutic embolization of aneurysmal bone cysts in five patients are described. Transcatheter arterial embolization was performed with Ivalon and Gelfoam particles and Gianturco coils. The postembolization period was characterized by complete relief of pain and decrease in size of the aneurysmal bone cyst in all patients. In patients whose follow-up was longer than 12 months, sclerosis and recalcification of bone were present. There were no complications.     

Enchondroma with secondary aneurysmal bone cyst

An enchondroma with complex cystic changes of the proximal femur is described in a 13-year-old male. The case illustrates a unique presentation of an enchondroma and reinforces the importance of considering the presence of secondary aneurysmal bone cysts in both benign and malignant lesions of bone.