小儿四肢长骨嗜酸性肉芽肿的影像学诊断

目的：探讨小儿四肢长骨嗜酸性肉芽肿（EG ）的影像学表现。方法回顾性分析26例经临床病理证实的小儿长骨EG患者影像学资料，包括26例X摄片，12例C T检查，和5例M RI扫描检查。结果26例中单发病灶17例，多发病灶9例（包括四肢长骨多发4例，累及其它骨骼5例），受累的四肢长骨包括股骨15例，肱骨9例，胫骨4例，腓骨及桡骨各1例，病灶位于骨干12例，干骺端18例，骨骺3例。X线平片15例病灶呈单发或多发囊状，部分边缘硬化，局部骨质呈膨胀性、溶骨性破坏，6例病灶呈小囊状破坏，4例骨膜层状增厚；C T扫描12例表现髓腔扩大，内见软组织肿块填充，骨皮质变薄，破坏，3例在骨松质区或骨髓腔内呈囊状破坏。M R检查均表现病灶中心 T1 WI多呈低或等低信号， T2 WI呈高或等高混杂信号，周边多呈长T1、长T2信号，STIR病灶多呈混杂高信号。结论小儿四肢长骨EG影像学表现多样，易与肿瘤或肿瘤样病变相混淆，合适的影像学检查，并密切结合临床表现及随访观察，有助于准确诊断。

Imaging diagnosis of eosinophilic granuloma in pediatric limb long bone

Objective To investigate imaging findings of in eosinophilic granuloma （EG） pediatric limb long bone .Meth-ods Imaging date of 26 cases of pediatric EG in limb longbone confirmed by clinical pathology were retrospectively ana-lysed ,including 26 cases of X-ray digital Radiography ,12 cases of CT examination and 5 cases of MRI inspection .Results There were 17 cases of single lesion and 9 cases of multi-focal in all 26 cases patients .The multi-lesions involved limb long bone in 4 cases ,involved other bones in 5 caese .The limb long bone involvement included 15 cases of femur ,9 of hume-rus ,4 of tibia ,1 of fibula and radius each respectively .The lesions in 12 cases located in backbone ,18 cases in metaphys-is ,3 cases in osteoepiphysis .In X-ray plain film ,the lesions in 15 cases presented single or multiple cyst ,edge hardening partly ,local sclerotin was swelling and dissolving destructed ,lesions in 6 cases presented cystic destroyed ,the periosteum involved in 4 cases were lamellarly thickened .In CT scan ,12 cases displayed that the medullary cavity expansion and soft tissue mass filling in the medullary cavity were involved ,the bone cortex were thinned and destroyed ,the cancellous bone area or the marrow cavity in 3 cases were cystic destroyed .In all patients’ MRI examination ,the lesion centre presented hypo or isointensity sign on T1 WI ,hyperintensity or iso-hyperintensity mixed sign on T2 WI ,lesions around presented hy-pointensity sign on T1WI and hyperintensity sign on T2WI ,mixed hyperintensity sign on STIR .Conclusion The imaging manifestations of pediatric limb long bone EG were various ,easily confused with tumors or tumor-like lesions .The appro-priate imaging examination ,combining clinical observation and follow-up closely ,contributed to an accurate diagnosis .