儿童颅骨嗜酸性肉芽肿的影像学诊断

目的：探讨儿童颅骨嗜酸性肉芽肿（EG）的影像学表现,以提高临床对此病的诊断水平。方法：回顾性分析经临床病理证实的20例颅骨EG的影像资料,包括X线摄片检查2例,CT检查20例,MRI检查4例（其中2例增强扫描）。结果：20例中16例单发病灶,4例多发病灶,共26个病灶,累及颞骨13个,额骨7个,枕骨4个,顶骨2个。X线检查2例均表现为边缘清晰、锐利的圆孔状骨质破坏;CT检查示26个病灶,7个呈溶骨性破坏,19个呈边界清晰的穿凿样破坏,21例存在软组织肿块;MRI检查示4例骨质破坏区软组织肿块形成,与脑灰质相比,在T1、T2加权均呈等信号,增强扫描明显强化。结论：儿童颅骨EG的CT及MRI表现具有一定特征性,结合临床病史,大多数病例可被准确诊断。MRI对观察软组织肿块成分及病灶侵犯范围有重要价值。

Imaging diagnosis of eosinophilic granuloma of skull in children

Objective： To investigate the image manifestation and improve the ability of diagnosis of skull eosinophilic granuloma in chidlren. Methods： Imaging data of skull eosinoplilic granuloma in children-retrospec- tive analysis of 20 cases by X-ray, CT and MRI scan, included： 2 cases of X-ray, 20 cases of CT scan, 4 cases of MRI scan （including 2 cases of enhancement scanning）. Results： Out of 20 cases, single lesion was found in 16 cases, and multiple lesions were found in 4 cases. There were totally 26 lesions in all 20 patients, temporal bone （n=13）, frontal bone （n=7）, occipital bone （n=4）, parietal bone （n=2） were respectively being involved. The X-ray findings of 2 cases were clear, sharp edge of the circular hole shaped bone destruction. The CT scanning found 26 lesions, including 7 cases of osteolytic destruction, 19 cases of punched-out like bone defect, 21 cases of soft tissue mass. The MRI scanning revealed 4 cases of soft tissue mass adjacent to the osteodestructions. Compared with gray matter of the brain, MR showed isosignal intensity on T1WI and T2WI after intravenous injection of Gd-DTPA, the lesions showed enhanced remarkably. Conclusion： The CT and MR manifestations of children skull EG have certain characteristics. Combination of medical record may improve the diagnostic accuracy in the majority of cases. The MRI can accurately show the location, shape and extent of skull eosinophilic granuloma in children which is valuable in differential diagnosis of various causes.