髂骨原发囊样骨肿瘤及瘤样病变的影像学诊断

目的:分析髂骨囊样骨肿瘤及肿瘤样病变的影像学表现。方法:回顾性分析经穿刺或/和手术病理证实的46例髂骨囊样骨肿瘤及肿瘤样病变影像学表现。46例全部行X线片检查,38例行CT检查,20例行MRI检查(增强16例)。结果:46例中骨肿瘤29例,其中良性肿瘤12例(骨巨细胞瘤4例,内生软骨瘤、软骨母细胞瘤各2例,血管瘤、骨母细胞瘤、骨样骨瘤、软骨黏液样纤维瘤各1例),恶性肿瘤17例(恶性巨细胞瘤、骨恶性纤维组织细胞瘤各1例,软骨肉瘤、淋巴瘤各4例,骨肉瘤7例),肿瘤样病变17例(单纯性骨囊肿1例,邻关节骨囊肿、动脉瘤样骨囊肿、嗜酸性肉芽肿各2例,骨纤维异常增生症10例)。发病部位为髂翼39例,髋臼7例。病变主要表现为髂骨囊样骨质破坏,呈膨胀性改变30例,硬化环形成24例,病变内见钙化灶14例,软组织肿块20例。结论:常见的髂骨囊样骨肿瘤和肿瘤样病变一般都具有某些特征性的CT表现,必要时综合X线、MRI表现,可提高定性诊断符合率。

Imaging Diagnosis of Primary Cystic Tumors and Tumor-like Lesions of Ilium

Objective:To study the imaging diagnosis of primary cystic tumors and tumor-like lesions of ilium.Methods:The imaging features of 46 cases of primary cystic tumors and tumor-like lesions of ilium confirmed by biopsy or/and operating pathology were reviewed.All of 46 cases underwent X-ray examinations,38 cases were examined by CT and 20 cases by MRI (16 of them receiving contrast enhanced MRI).Results:In 46 cases,29 patients had bone tumor,including 12 cases benign tumors (4 cases of giant cell tumor;2 cases of enchondroma and chondroblastoma each;1 case of hemangioma,osteoblastoma,osteoid osteoma and chondromyxoid fibroma each) and 17 cases malignant tumors (1 case of maligant giant cell tumor and maligant fibrous histocytoma of bone each;4 cases of chondrosarcoma and malignant lymphoma each;7 cases of osteosarcoma),and 17 patients had tumor-like lesions (1 case of bone cyst; 2 cases of secondary aneurysmal bone cyst,eosinophilic granuloma and intraosseous ganglion each;10 cases of fibrous dysplasia).The lesions located at ala of ilium in 39 cases,at acetabulum in 17 cases.The lesions showed cystic bone destruction in all cases,expansile lesion in 30 cases,with sclerotic margin in 24 cases,calcification within the lesion in 14 cases,soft tissues mass located at in 20 cases.Conclusion:There are some characteristic CT findings in the primary cystic tumors and tumor-like lesions of ilium which are helpful to the diagnosis.The diagnostic accuracy of the lesions can be improved by combining plain film and MRI findings.