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目的:探讨骨恶性淋巴瘤影像学表现及诊断价值。方法:回顾性分析29例经手术病理证实的骨恶性淋巴瘤的临床和影像学资料,29例患者均行相应部位X线及CT检查,17例行MRI检查。结果:X线、CT表现为骨质破坏溶骨型6例,浸润型12例,骨质硬化型3例,混合型8例,包绕病骨生长并超越骨病变范围的软组织肿块14例,CT增强扫描呈中等均匀或不均匀强化;MRI表现为T2WI呈等或稍高信号12例,呈明显均匀或不均匀强化。结论:X线对骨恶性淋巴瘤的检查有重要作用,其象牙椎、椎体多骨多灶性破坏、长骨溶骨性破坏等对本病有重要诊断价值。CT对本病的骨质破坏、硬化反应、骨膜反应、软组织侵犯等观察优于X线。MRI相对特征影像学特点为骨膜反应轻、T2WI稍高信号、软组织肿块较大、增强扫描不均匀强化。MRI对淋巴瘤浸犯性破坏所致的早期骨质改变,以及发现骨髓的早期侵犯优于X线和CT。
Objective: To investigate the imaging findings and diagnostic value of malignant lymphoma of bone Methods: The clinical and imaging data of 29 patients with pathologically confirmed malignant lymphoma of bone were retrospectively analyzed. All the 29 patients underwent X-ray and CT examinations and 17 patients underwent MRI examination. Results: X-ray and CT showed osteolytic osteolysis in 6 cases, infiltration in 12 cases, osteosclerosis in 3 cases, mixed-type in 8 cases, surrounded by bone disease and beyond the scope of bone lesions in 14 cases of soft tissue mass, CT enhanced scan was uniform or uneven enhancement; MRI showed T2WI was equal or slightly higher signal in 12 cases, showed significantly uniform or uneven enhancement. Conclusion: The X-ray has an important role in the examination of malignant lymphoma of bone. The multifocal destruction of the vertebral body, lumbar osteoblasts and osteolytic destruction of long bones are important diagnostic values for this disease. CT of the disease, bone destruction, sclerosis, periosteal reaction, soft tissue invasion and other observations superior to X-ray. MRI characteristics of the relative features of the periosteal reaction is light, T2WI slightly higher signal, larger soft tissue mass, enhancement scan uneven enhancement. Early MRI bone marrow involvement of lymphoid lesions caused by early bone changes, and early detection of bone marrow is superior to X-ray and CT.