MRI诊断骨嗜酸性肉芽肿的价值

目的：探讨MRI对骨嗜酸性肉芽肿的诊断及分期价值。方法：回顾性分析经病理证实的27例骨嗜酸性肉芽肿的临床和影像学资料。结果：病灶单发23例，多发4例。4例病灶呈斑片状骨破坏，边缘清但不规则；14例呈类圆形骨质破坏，边界清楚、规则，周围骨髓及软组织明显肿胀；9例呈斑片状骨破坏伴周围硬化，中间伴见分隔。所有病灶T1WI均呈低信号，T2WI呈低于周围骨髓的稍高信号，STIR呈高信号；三维容积快速采集（LAVA）动态增强扫描4例急性期病灶呈持续性环状明显强化，14例肉芽肿期病灶呈均匀持续性强化，9例修复期病灶早期强化不明显而延迟期呈轻度环状、分隔状强化；6例出现骨膜反应。结论：MRI能充分显示骨嗜酸性肉芽肿痛变的范围、细节，能提示病变的分期，对临床诊断、治疗本病具有重要的参考价值。

The value of MRI in the diagnosis of eosinophilic granuloma of bone

Objective：To study the value of MRI in the diagnosis and staging of eosinophilic granuloma of bone. Meth- ods：Clinical data and imaging manifestations of 27 cases with pathology proved eosinophilic granuloma of bone （EGB） were retrospectively analyzed. Results：Of the 27 cases, there were 23 cases with single and 4 cases with multiple lesions. 4 cases showed patchy bony destruction with clear yet irregular margin;while 14 lesions showed round bony destruction with clear and regular margin,obvious swelling of bone marrow and soft tissue could also be seen. Patchy bone destruction accompa- nied with sclerotic rim and central septation were assessed in 9 lesions. On MRI, all lesions showed slightly low signal in- tensity On TI WI,slightly high signal but lower than that of surrounding bone marrow on T2 WI and high signal on STIR. Dynamic enhanced scanning with 3D volumetric acquisition sequence （LAVA） showed persistent and significant ring-like enhancement in 4 patients of acute stage, 14 patients showed homogeneous persistent enhancement in granulomatous stage, 9 patients in repair stage showed no enhancement in the early phase,while mild septation enhancement in delayed phase. Six cases showed periosteal reaction. Conclusions： MRI is helpful in fully displaying the extent and details of EGB, provides the information of staging,plays an important role in the clinical diagnosis and treatment guidance.