脊柱嗜酸性肉芽肿的影像学诊断

目的:探讨脊柱嗜酸性肉芽肿的影像学表现及鉴别诊断.方法:回顾性分析21例经病理证实的脊柱嗜酸性肉芽肿的X线、CT和MRI表现.结果:21例中发生在颈椎5例,胸椎10例,腰椎6例;X线检查示17例(17/21)椎体呈楔形改变或椎体变扁,3例呈囊状破坏,4例显示软组织肿块,3例椎间隙变窄.7例患者行CT检查,CT主要表现为椎体不规则破坏和椎旁软组织肿块.8例行MRI检查,显示椎体破坏、信号异常和椎旁软组织肿块,3例软组织肿块在冠状面和矢状面呈套袖状,相邻椎间盘信号无明显改变.结论:脊柱嗜酸性肉芽肿的影像学表现具有一定的特征性,X线平片是其诊断基础,同时结合CT尤其是MRI检查,能够提高诊断和鉴别诊断能力,但该疾病的正确诊断有赖于临床、病理和影像表现相结合.

Imaging Diagnosis of Eosinophilic Granuloma of Spine

Objective:To study the imaging features of the spine eosinophilic granuloma (EG) and its role in the differential diagnosis.Methods:The X-ray,CT and MRI findings of pathology proven spinal eosinophilic granuloma in 21 patients were retrospectively reviewed.Results:The location of EG lesions were in cervical vertebrae (n=5),thoracic vertebrae (n=10), lumbar vertebrae (n=6).On radiography,17 lesions demonstrated wedged or flattened vertebrae,3 lesions with cystic bony destruction,4 patients had perivertebral soft tissue mass and 3 patients had intervertebral space narrowing.CT scan were performed in 7 patients showing irregular bony destruction with soft tissue masses in all cases.MRI were performed in 8 patients,showing irregular bony destruction with abnormal signal intensities and perivertebral soft tissue masses.Sleeve sign were showed in 3 patients in coronal and sagittal images.No obvious change of signal intensity was displayed in adjacent intervertebral discs.Conclusion:Eosinophilic granuloma of the spine showed characteristic imaging features,radiography is the main method for the diagnosis.However,the capability of diagnosis and differential diagnosis might be improved when CT or MRI is used.Yet accurate diagnosis still depends on the combination of clinical signs and symptoms,pathology and imaging features.