共查询到17条相似文献,搜索用时 78 毫秒
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患者,男性,30岁,近2年来感右大腿疼痛,活动后加重,2周前由于剧烈运动后右下肢活动不能,遂入我院就诊。查体:右股骨上段压痛明显,皮肤稍显红肿,右髋活动受限。X线平片见:右股骨上段粗隆间呈多发皂泡样囊状透光区,周围有密度较高的硬化边缘,病灶内有残余骨嵴,后外缘皮质变薄,轻度膨胀,未见骨膜反应,毗邻骨边界尚清晰。初步诊断:右股骨上段骨巨细胞瘤(继发病理性骨折)。手术所见及病理诊断:囊肿由薄层囊状骨壳组成,上覆盖骨膜和由骨膜形成的薄层骨壁,囊腔内充满大量海绵状血池,其中多数充以暗红色血液。病理诊断:动脉瘤样骨囊肿。1 讨 论1 1… 相似文献
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目的:探讨骨巨细胞瘤(GCT)合并动脉瘤样骨囊肿(ABC)的影像学表现及鉴别特点,以提高其诊断水平。方法:回顾性分析经手术、病理证实的14例GCT合并ABC的影像学表现。所有患者均行X线检查,11例行CT检查,12例行MRI扫描,2例行全身骨显像。对其影像学表现和病理结果进行对照。结果:14例中,病灶位于股骨6例,胫骨3例,尺骨3例,腓骨1例,桡骨1例。X线及CT表现为膨胀性骨质破坏,病灶密度不均匀,皮质变薄或中断。肿瘤实质区T1WI呈等或低信号、T2WI呈以高信号为主的混杂信号,病灶内多伴囊变和液-液平面,病灶周围骨质水肿,增强扫描病灶大部分呈明显强化。全身骨现象主要表现为病变部位片状放射性核素浓聚,显影不均匀。结论:GCT合并ABC的CT、MRI表现具有一定特征,结合X线、全身骨显像检查,有助于提高该病的术前诊断准确率,为临床治疗方案的制订提供帮助。 相似文献
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骨巨细胞瘤继发动脉瘤样骨囊肿的影像诊断 总被引:4,自引:0,他引:4
目的提高骨巨细胞瘤(GCT)继发动脉瘤样骨囊肿(ABC)的认识和影像诊断水平。方法搜集经手术病理证实的12例GCT继发ABC的X线、CT、MRI和病理学资料,分析和总结其影像征象。结果12例中6例病变发生于长管状骨,6例发生于盆骨。12例病变X线均表现为囊状膨胀性溶骨性骨破坏,10例呈偏心性破坏,2例为中心性破坏;4例病灶内出现骨性分隔,6例骨皮质中断,4例出现软组织肿块,有明显硬化边者2例。10例行MR平扫和增强检查,均呈多囊的囊实性膨胀性肿块,8例为边缘性实性结节,2例为实性基础上的广泛囊变,全部患者均可见多个液一液平面,7例出现软组织肿块;1例肿块内可见局灶性含铁血黄素沉着。8例行螺旋cT平扫、增强、CT血管成像(CTA)和三维(3D)多平面重组(MPR),病变显示为囊实性肿块,骨皮质破裂并形成软组织肿块5例,6例肿块内出现液.液平面,全部肿块实质性部分和囊壁明显强化,囊性部分不强化,3例肿块内可见增粗迂曲的供血动脉,未发现动静脉畸形。12例手术所见和术后病理显示肿块均由多发含血的囊腔和实性部分组成,病理诊断结果均为GCT伴发ABC,其中Ⅱ级GCTl0例,Ⅲ级2例。结论GCT伴发ABC并不少见,充分理解其病理组织学基础,并选择恰当的影像检查方法(X线+MRI或X线+CT)对其正确诊断非常重要。 相似文献
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【摘要】目的:探讨CT直方图分析技术在鉴别骨巨细胞瘤(GCT)和动脉瘤样骨囊肿(ABC)中的价值。方法:回顾性分析经术后病理证实的63例GCT和31例ABC的CT平扫图像。由两名具有3年经验的放射科医生分别通过CT图像评估肿瘤的形态特征,并对肿瘤整体绘制感兴趣区(ROI)获得直方图特征。采用卡方检验、独立样本t检验或Mann-Whitney U检验对两组数据进行比较,针对差异有统计学意义的特征进行二元Logistic回归及受试者操作特征(ROC)曲线分析,构建临床模型、直方图模型及联合模型,并分别与低年资和高年资放射科医生的诊断效能进行了对比。结果:骨巨细胞瘤和动脉瘤样骨囊肿的年龄、3个形态特征(病变位于膝关节周围、生长模式、具有液-液平面)及7个直方图特征(平均值、第90、95百分位数、不均匀性、峰度、熵、标准差)的差异具有统计学意义(P<0.05),其中年龄、具有液-液平面、峰度及标准差被纳入二元Logistic回归模型,临床模型、直方图模型、联合模型和低年资医生、高年资医生的AUC值分别为0.785、0.777、0.880、0743和0.863。结论:CT直方图分析技术在鉴别骨巨细胞瘤和动脉瘤样骨囊肿中具有重要价值,联合临床特征可进一步提高诊断效能,联合特征模型的效能显著优于低年资医生,并可于高年资医生相媲美。 相似文献
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患者 男,39岁,左胸壁疼痛3月入院.查体:双侧前上胸壁不对称,左侧前胸壁局限性隆起,质地较硬,轻压痛,周围无红肿,皮温不高.实验室检查:碱性磷酸酶169 U/L.
影像学检查:X线示左侧第2肋呈膨胀性破坏并稍高密度肿块形成(图1).CT横轴位示左第2肋见范围约9.0 cm×4.5cm的膨胀性骨质破坏,破坏区内见软组织肿块,且肿块突破骨皮质,密度不均,CT值约29~60 HU,增强后呈轻度不均匀强化,CT值30~70 HU(图2~4);曲面重建(CPR)示破坏区骨皮质不连续,内有不规则斑片状致密灶,边缘见硬化边,未见骨膜反应,左肺受压(图5). 相似文献
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J. Ghekiere E. Geusens L. Lateur I. Samson R. Sciot A. L. Baert 《European radiology》1998,8(6):992-995
A case of chondroblastoma of the patella combined with an aneurysmal bone cyst is presented. Chondroblastoma of the patella
is an uncommon, benign neoplasm. On the other hand, secondary aneurysmal bone cyst is frequently associated with giant cell
tumour of chondroblastoma.
Received 15 July 1997; Revision received 6 November 1997; Accepted 13 November 1997 相似文献
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An enchondroma with complex cystic changes of the proximal femur is described in a 13-year-old male. The case illustrates a unique presentation of an enchondroma and reinforces the importance of considering the presence of secondary aneurysmal bone cysts in both benign and malignant lesions of bone. 相似文献
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A correlated histologic and radiographic study of nine giant-cell tumors, six aneurysmal bone cysts, and one combined lesion is presented. Clinical findings and plain radiographic appearances were found to overlap. Angiographically, the giant-cell tumors were richly vascularized, with a marked intratumoral contrast uptake, occasional irregular tumor vessles, a prominent peritumoral arterial net-work, and early draining veins. Microscopic examination revealed fine, capillary-like and somewhat larger, angulated, sinusoid vessels, and occasional small, bloodfilled cysts within the tumor. Conspicuous arteries, veins, and capillaries surrounded the tumor. The aneurysmal bone cysts at angiography were predominantly avascular in the interior, surrounded by a thin hyperemic zone in the peritumoral tissue, with sometimes early filling of veins. Microscopically, the aneurysmal bone cysts showed large, anastomosing, bloodfilled vascular channels, and a moderate number of capillaries within the solid, fibrous areas and the granulation tissue. It is concluded that angiography, particularly with a subtraction technique, may be a valuable diagnostic method in the pre-operative differentiation of giant-cell tumors from aneurysmal bone cysts. 相似文献