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上期试题：脊柱动脉瘤样骨囊肿好发于A A.椎体 B.椎管 C.附件 D.椎旁 E.椎间孔 患者，男，22岁，于2年前无明显诱因下发现右肩胛部肿物，无明显疼痛，近1周来，右肩胛部肿物明显增大伴右肩部持续性疼痛，无放射痛，无畏寒发热，无恶心呕吐。 ↑右侧肩胛骨体部呈膨胀性骨质破坏，其内可见不规则形密度减低区，并见骨性分离。 ↑CT平扫右肩胛骨体部见膨胀性、溶骨性骨质破坏区，部分骨皮质破坏中断，肿块内见斑点、线样骨嵴样结构，未见软组织肿块。 ↑横轴位T2WI、横轴位T2WI抑脂像、冠状位T2WI抑脂像、矢状位T2WI抑脂像 右侧肩胛骨体部见一巨大分叶状肿块，于T1WI像上呈等信号，T2WI及T2WI抑脂像上呈高信号，其内及周边见分隔样低信号影，边界清楚。 软骨黏液性纤维瘤发生于幼稚的黏液样间胚叶细胞，具有分化为软骨和产生胶原纤维的特性，而非起源于软骨细胞后发生黏液样变，本病占原发骨肿瘤的1.4%-3%，占所有骨肿瘤的1.3%。 Cartilage mucous sex fibroma in the naive myxoid germ layer between cells, differentiated into cartilage and the production of collagen fiber characteristics, rather than from myxoid change, in the aftermath of the cartilage cell disease accounted for 1.4% of primary bone tumors - 3%, accounting for 1.3% of all bone tumors. 发病年龄多在10-30岁，好发于下肢长管骨，其中以胫骨上端最多，其次为股骨、腓骨、跟骨、跖骨。上肢骨以肱骨多见，扁骨中可见于髂骨、脊柱、肋骨、颅骨等，发生于肩胛骨者少见，据国内刘子君统计289例软骨黏液样纤维瘤患者，只有5例发生于肩胛骨。该例软骨黏液样纤维瘤的基本影像学特征为偏心性、膨胀性、囊状骨质破坏，骨皮质膨胀变薄，并形成骨壳，囊壁可见伸向囊内的骨嵴，MRI表现为病变呈稍长T1/长T2信号（于邻近肌肉相比），T2WI抑脂像上呈高信号，信号不均匀，所见骨嵴在各序列上均呈低信号。增强扫描后病灶呈不均匀性强化。 The onset age is 10-30 years old, good hair in the lower extremity long tube bone, among them, the tibia upper end most, the femur, fibula, heel bone, metatarsal bone. Along with the humerus, flat bones are visible in ilium, spine, ribs, skull, such as occurred in the shoulder blade are rare, according to the domestic zi-jun liu 289 cartilage myxoid fibroma patients, only 5 cases occurred in the shoulder blade. Cartilage myxoid fibroma in this case the radiographic features of the basic mind, swelling, cystic bone destruction, bone cortex thins, and formation of bone and shell, inside the capsule wall visible to bone crest, MRI performance for lesions has a long long T1 / T2 signal (compared to adjacent muscle), a high signal on T2WI fat suppression like, signal is uneven, can see the bone ridge which has low signal in each sequence. The lesion was enhanced after scanning. 本例应与骨巨细胞瘤、成软骨细胞瘤鉴别。骨巨细胞瘤发病年龄较大，好发于骨端，紧邻关节面生长，易向骨突部位发展，骨性间隔较细，膨胀更明显，边缘无硬化，无钙化灶。成软骨细胞瘤起于骨骺或骺板，病灶较小，膨胀较轻，常伴有关节积液，内多有钙质样高密度影，一般无粗厚的骨嵴。 This case should be identified with osteocytoma and chondroblastoma. The incidence of bone giant cell tumor is relatively large, so it can be found at the bone end, which is proximal to the growth of the joint surface. It is easy to develop in the bone region, and the bone spacing is thinner, and the expansion is more obvious, with no calcification of the edges. Chondroblastoma arises from the epiphysis or epiphysis plate, the lesion is small, the expansion is relatively light, often accompanied by the joint effusion, there are calcium like high density shadow, generally not thick bone crest. 本期试题：骨内膨胀性病变无周围硬化性边缘，是下述哪一疾病的X线征象之一？ A．软骨黏液样纤维瘤 B．骨巨细胞瘤 C．囊性骨纤维异样增殖症 D．骨化性纤维瘤 E．骨囊肿
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来自： zskyteacher > 《西航港之临床影像学习平台》
