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目的分析肩胛骨嗜酸性肉芽肿的影像学表现,探讨其临床特点和鉴别诊断价值。方法分析8例肩胛骨嗜酸性肉芽肿的临床和X线、CT及MRI影像学资料。结果 8例患者中,所有病灶均累及关节盂部。X线平片上所有病灶表现为溶骨性骨质破坏,局部骨皮质变薄。7例行CT检查者中,4例病灶骨质破坏区可见残存细小骨碎片。6例病灶可见周围骨皮质不规则破坏中断,其中3例可见软组织肿块形成,1例见骨膜反应;1例骨皮质规则完整。1例全肩胛骨弥漫性病灶呈囊状膨胀性骨质破坏,周围见多发结节及团块状软组织肿块,同侧腋窝见多发肿大淋巴结。2例行MRI检查者病灶表现为等T_1、长T_2信号,其中1例骨皮质中断破坏,周围软组织见大片稍长T_1、长T_2信号水肿灶,T_2WI及脂肪抑制序列可见病变边缘环绕线状低信号影。结论儿童及青少年肩胛骨尤其关节盂出现溶骨性骨质破坏,相邻骨皮质变薄或破坏中断,可伴有软组织肿块,影像学改变明显而临床症状轻微,应考虑到嗜酸性肉芽肿的可能性。
Objective To analyze the imaging manifestations of scapular eosinophilic granuloma and investigate its clinical features and differential diagnosis value. Methods Eight cases of scapular eosinophilic granuloma were analyzed by X-ray, CT and MRI. Results Of the 8 patients, all the lesions involved the glenoid cavity. All lesions on X-ray showed osteolytic osteolysis and local cortical thinning. 7 routine CT examination, 4 cases of bone lesions seen in the area of remnants of small bone fragments. In 6 cases, the surrounding cortical bone was disrupted irregularly, of which 3 cases showed soft tissue mass formation, 1 case had periosteal reaction and 1 case had complete cortical rules. One case of all scapular diffuse lesions showed cystic swelling of the destruction of bone around the see multiple nodules and mass-like soft tissue mass, ipsilateral axillary see multiple swollen lymph nodes. 2 cases of MRI examination of lesions showed T_1, long T_2 signal, including 1 case of cortical disruption, the surrounding soft tissue to see a little longer T_1, long T_2 signal edema, T_2WI and fat suppression sequence can be seen around the edge of lesion marginal low Signal shadow. Conclusions In children and adolescents, osteolytic bone destruction occurs in the scapula, especially in the glenoid cavity. Thinning or disruption of adjacent cortical bone may be associated with soft tissue mass. The imaging changes obviously and the clinical symptoms are slight. The possibility of eosinophilic granuloma should be considered Sex.