骨内脂肪瘤的影像学表现及其诊断价值

目的探讨骨内脂肪瘤的X线、CT及MRI的影像学表现特点及其诊断价值。方法收集经病理证实或影像学结合临床诊断的7例患者8个骨内脂肪瘤病灶资料,分析其影像学表现特征。结果 X线表现为边界清晰透亮区,形态不规则,1个病灶内可见钙化,2个病灶显示骨间隔,6个病灶边缘硬化。CT表现为单一脂肪密度2个病灶,以脂肪为主混杂密度5个病灶,4个病灶有轻度膨胀感,4个病灶显示骨嵴或分隔,5个病灶内见钙化或骨化,6个病灶边缘有硬化。MRI表现出脂肪组织特征性的短T1长T2信号,同时脂肪抑制序列呈低信号,合并钙化、纤维化、黏液样变及坏死则信号混杂。均未见骨皮质破坏、骨膜反应或软组织肿块。结论骨内脂肪瘤的影像学表现多种多样,但均含有特征性的脂肪成分,病灶内钙化和病灶边缘硬化是其重要征象,X线诊断价值有限,CT和MRI依据含有特征性的脂肪成分,能正确诊断,避免不必要的穿刺或手术。

Study on imaging features and diagnostic value of intraosseous lipoma

Objective To study the imaging features of the intraosseous lipoma radiograph, CT and MR and their di-agnostic value. Methods Analysis of the imaging features of 7 intraosseous lipoma patients arid 8 data of intraosse ous lipoma nidus were confirmed by pathology or imaging and clinical diagnosis. Results Radiograph showed that the edges of nidus was relatively clear translucence arid its shape was irregldar; 1 case of them has calcification within the lesion; there are septation bone in 2 lesions;the edges was hardened in 6 lesions, in CT, 2 lesions expressed as sin-gle pure fat density and low density fat-based mix in 5 lesions; 4 lesions were mild expansion; there are crest bone or septation in 4 lesions; 5 lesions have the calcification or ossification in the center of them; the edges are hardened in 6 lesions, in MR, the short T1 signal arid long T2 signal with the adipose tissue characteristics can be revealed; Fat suppression would lead to low signal, while the calcification, fibrosis, mucoid degeneration, necrosis would lead to heterogeneous signal. There was no cortical destruction, periosteal reaction or soft tissue mass in the studied cases. Conclusions There are varieties of intraosseous lipoma imaging manifestations, all of them with characteristic in tralesional fat. intralesional calcification and the harden edges of lesion are important signs of intraosseous lipoma. The value of the X-ray diagnosis is limited, however, through observing the intralesional fat, CT and MR can diag nose correctly, avoid unnecessary puncture or surgery.