CT and MRI findings of bone lipoma and angiolipoma and review of literature
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摘要:
目的探讨骨脂肪瘤及血管脂肪瘤的CT及MRI表现。 方法收集手术病理证实的9例骨脂肪瘤及血管脂肪瘤的临床及影像学资料，9例术前8例接受CT扫描，3例接受MRI检查。 结果9例中骨脂肪瘤6例，骨血管脂肪瘤3例。6例骨脂肪瘤发生于骨内4例，骨旁2例。骨内脂肪瘤跟骨1例，距骨1例，眶骨1例，肱骨1例。骨旁脂肪瘤颅骨1例，股骨1例。骨血管脂肪瘤发生于肋骨1例，颅骨1例，椎骨1例。骨内脂肪瘤CT显示病变骨质呈轻度膨胀性改变，边缘见轻度硬化环，病灶内见脂肪密度及条弧形、结节状钙化，MRI显示病灶T1WI呈高信号，PDWI及T2WI抑脂序列呈低信号。骨旁脂肪瘤CT呈不均匀高密度团块，MRI显示病灶T1WI呈高信号，T1WI及T2WI抑脂序列呈低信号。3例骨血管脂肪瘤CT显示病变骨质呈显著膨胀性改变，骨破坏边缘及内部见多发骨嵴及粗大骨小梁，高密度骨针呈放射状、簇状或不规则排列。 结论骨内脂肪瘤及血管脂肪瘤CT及MRI表现均以脂肪成分为主要特征，骨旁脂肪瘤CT以骨化性团块为特征，骨血管脂肪瘤骨质膨胀性改变较骨内脂肪瘤显著，病灶边缘及中心以多发骨嵴及粗大骨小梁为特征。 Abstract:ObjectiveTo investigate the CT and MRI manifestations findings of bone Intraosseous lipoma and angiolipoma and review of literature to improve the understanding of the disease. MethodsThe clinical and imaging data of 9 cases of Intraosseous lipoma and angiolipoma confirmed by surgical and pathology were collected, 8 cases received CT scan before operation, and 3 case received MRI examination. ResultsAmong the 9 cases, 6 cases were osteolipoma and 3 cases were bone angiolipoma. 6 cases of bone lipoma occurred in 4 cases in the intraosseous lipoma and 2 cases parosteal lipoma. Anong the 6 case osteolipoma, occurred in 1 case of calcaneus, 1 case of talus, 1 case of orbital bone, and 1 case of humerus. Among the 2 cases parosteal lipoma, there was 1 case of cranial and 1 case of femur. Angiolipoma of the bone occurred in 1 case of ribs, 1 case of skull, and 1 case of vertebrae.CT of the intraosseous lipoma showed mild swelling changes in the bone mass, mild sclerosis rings at the edges, fat density and bar- shaped, nodular calcifications in the lesions, MRI showed that the lesions showed high signal intensity on T1WI, PDWI and T2WI suppression Lipid sequence showed low signal. The CT scan of the parosteal lipoma showed uneven high- density masses. the lesions showed high signal intensity on T1WI, and the lipid suppression sequence on PDWI and T2WI showed low signal intensity. 3 cases of Intraosseous angiolipoma showed significant expansive changes. CT showed multiple crest and large bone trabecular at the edges and inside of bone destruction. ConclusionThe CT and MRI featrues of intraosseous lipomas and angiolipomas are mainly characterized by fat components, CT of parosteal lipomas are characterized by ossifying masses. Intraosseous angiolipoma has a more pronounced change in bone swelling than intraosseous lipoma. The edges and center of the lesion were characterized by multiple bone crests and large bone trabecular. -
图 1 男性，45岁，跟骨骨内脂肪瘤
A: CT矢状位骨窗重建显示跟骨轻度膨胀性骨质破坏, 边缘清晰, 可见硬化环; B~C:横轴位软组织窗显示病灶内混合脂肪密度与片絮状软组织密度, 其内见条弧形钙化.
Figure 1. Male patient, forty-five years old, with an lipoma of calcaneus.
图 2 女性，44岁，颅骨骨旁脂肪瘤
A: CT显示左额骨颅内板下团块状不均匀高密度影, 相邻颅骨内板受压; B: T1WI显示病灶呈高信号; C: T2WI脂肪抑制序列显示病灶呈低信号.
Figure 2. Female patient, forty-four years old, with an paraosseous lipoma of skull.
图 3 男性，49岁，肋骨血管脂肪瘤
A:软组织窗显示右侧第3背肋近椎肋关节处膨胀性溶骨破坏; B:病灶内呈脂肪密度, 边缘见多发骨嵴; C:粗大骨小梁呈放射状, 相互交错形成间隔.
Figure 3. Male patient, forty-nine years old, with an angiolipoma of rib.
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