髂骨原发性淋巴瘤的影像学表现

目的：探讨髂骨原发性淋巴瘤CT、MRI表现特点，以提高对该病的诊断和鉴别诊断能力。方法回顾性分析经手术病理证实或经穿刺细胞学检查的6例髂骨原发性淋巴瘤的CT及MRI影像学表现。结果6例均为单发，6例行CT平扫，2例CT增强检查，CT主要表现为溶骨性骨质破坏4例，浸润性骨质破坏1例，混合性骨质破坏1例，5例周围伴有较大软组织肿块，髋关节受累3例，骶髂关节受累2例，关节间隙保持正常。2例行CT增强扫描均表现为明显不均匀强化。4例行MRI检查，T1WI主要表现为低信号3例，等信号1例，T2WI主要表现为以高信号为主的混杂信号，增强扫描病灶不均匀明显强化。结论髂骨原发性淋巴瘤与其它恶性骨肿瘤鉴别困难，但具有以下特点：全身症状轻、溶骨型骨质破坏伴或不伴骨膜反应及骨皮质增厚、软组织肿块明显而骨质破坏轻微、病变有包绕关节趋势（关节间隙保持正常）。

CT and MRI Features of Primary Lymphoma in Ilium

Objective To study the CT and MRI features of primary lymphoma in ilium in order to improve the diagnostic accuracy. Methods The CT and MRI images of 8 cases with primary malignant lymphoma in ilium were reviewed. All cases were conifrmed by operation and pathology. Results All cases with single destruction, 4 cases showed osteolytic destruction, 1 case showed lytic lesion, cortical bone appeared ″tumor tunnel″, which revealed high signal in T2-weighted MR imaging. Soft-tissue masses were mostly unappropriate size associated with little cortical destruction. Extension across joints persisted in normal joint space. Conclusion Primary lym-phoma in ilium is dififcult to differentiate from other tumors. However there are some characters：subclinical, lytic destruction with or without periosteal and endosteal reaction, unappropriate soft-tissue mass associated with little cortical destruction, and extension across joints with normal joint space.