颅底骨孤立性浆细胞瘤的影像学特征分析
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摘要
目的 总结颅底骨孤立性浆细胞瘤的CT和MRI影像学表现,以提高对该病的认识和影像诊断水平。方法 回顾性分析经手术病理证实的8例颅底骨浆细胞瘤患者的临床资料,其中男5例,女3例,8例均行CT平扫,6例行MRI平扫加增强,总结分析其临床特征及影像学表现。结果 7例CT平扫表现为均匀稍高密度影,1例均匀为等密度影,8例邻近骨质均呈溶骨性破坏,见残存骨质或钙化,均位于骨破坏区,均未见骨质硬化及骨膜反应。MRI表现为均匀等或稍短T1及均匀稍短或等T2信号4例,信号略混杂1例,肿瘤主体T1及T2稍短信号,内见点状长T1、长T2信号1例,增强后均呈明显均匀强化。结论 颅底骨孤立性浆细胞瘤具有一定的特征性影像学表现,其影像学特点有助于提高影像诊断符合率。
Objective To summarize and analyze the CT and MRI features of solitary plasmacytoma of bone in the skull base, in order to improve the accuracy of diagnosis. Methods Imaging materials of 8 patients with surgically and pathologically proved solitary plasmacytoma of bone in the skull base were retrospectively reviewed. Among the 8 patients, 5 were male and 3 were female. All patients had CT scanning and 6 patients underwent MRI to summarize and analyze the clinical features and imaging manifestations of patients. Results The tumors were homogeneous on CT scan with slight hyperdensity in 7 cases and isodensity in 1 case. All patients had osteolytic bone destruction with residual bone or calcification in the bone destruction area. No osteosclerosis or periosteal reaction was noted. By MRI, 4 cases showed homogeneous iso or slightly short signal intensity on T1 WI and slightly short or iso signal intensity on T2 WI, one case had slightly mixed signal intensity, the main body of tumors had slightly short signal on T1 WI as well as on T2 WI, and one case had punctuate long signal on T1 WI and T2 WI, with marked homogeneous enhancement. Conclusions Characteristic imaging findings could be observed in solitary plasmacytoma of skull base bone. With well knowledge of these imaging characteristics, the diagnostic accuracy of solitary plasmacytoma of skull base bone could be improved.
Objective To summarize and analyze the CT and MRI features of solitary plasmacytoma of bone in the skull base, in order to improve the accuracy of diagnosis. Methods Imaging materials of 8 patients with surgically and pathologically proved solitary plasmacytoma of bone in the skull base were retrospectively reviewed. Among the 8 patients, 5 were male and 3 were female. All patients had CT scanning and 6 patients underwent MRI to summarize and analyze the clinical features and imaging manifestations of patients. Results The tumors were homogeneous on CT scan with slight hyperdensity in 7 cases and isodensity in 1 case. All patients had osteolytic bone destruction with residual bone or calcification in the bone destruction area. No osteosclerosis or periosteal reaction was noted. By MRI, 4 cases showed homogeneous iso or slightly short signal intensity on T1 WI and slightly short or iso signal intensity on T2 WI, one case had slightly mixed signal intensity, the main body of tumors had slightly short signal on T1 WI as well as on T2 WI, and one case had punctuate long signal on T1 WI and T2 WI, with marked homogeneous enhancement. Conclusions Characteristic imaging findings could be observed in solitary plasmacytoma of skull base bone. With well knowledge of these imaging characteristics, the diagnostic accuracy of solitary plasmacytoma of skull base bone could be improved.
引文
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[20] 董帅,于德新,王青,等.斜坡脊索瘤的CT和MRI表现及误诊分析[J].实用放射学杂志,2018,34(9):1465-1467.
[21] 姜卫国,杨喜林,周韬.颅骨巨细胞瘤的CT诊断[J].中国医学影像技术,1998,14(9):651.
[22] 董立平,谢谦宇,夏宇.颅底骨巨细胞瘤的CT、MRI表现[J].中国中西医结合影像学杂志,2013,11(1):42-44.
[23] 曾雪明,马洪兵,周丹.恶性脑膜瘤的MRI诊断[J].实用放射学杂志,2018,34(2):184-186.
[2] Náara S,Amit M,Gil Z,et al.Plasmacytoma of the Skull Base:A Meta-Analysis[J].J Neurol Surg B Skull Base,2016,77(1):61-65.
[3] De Waal EG,Leene M,Veeger N,et al.Progression of a solitary plasmacytoma to multiple myeloma.A population-based registry of the northern Netherlands[J].Br J Haematol,2016,175(4):661-667.
[4] 张之南,郝玉书,赵永强,等.血液病学[M].第2版.北京:人民卫生出版社,2011:1078-1079.
[5] 张文娟,景红梅,克晓燕,等.12例骨孤立性浆细胞瘤的临床特点与预后回顾性分析[J].中国癌症杂志,2008,18(12):933-936.
[6] 敬婷,斯光晏,何其舟,等.孤立性浆细胞瘤的影像表现与鉴别诊断[J].中国临床医学影像杂志,2018,28(3):202-205,208.
[7] 侯健,郭垞.国际上新修订的骨髓瘤分类、疗效和预后判断标准介绍[J].中华血液学杂志,2004,25(4):251-253.
[8] 郭守娟,李国文,李红飞.12例骨孤立性浆细胞瘤临床分析[J].肿瘤基础与临床,2015,28(1):41-43.
[9] Ahn AI,Wren MK,Meyer TA.Skull base plasmacytoma with conductive hearing loss and an external auditory canal mass[J].Ear Nose Throat J,2012,91(7):E1-E5.
[10] Mohyeldin A,Prevedello DM,Jamshidi AO,et al.Nuances in the treatment of malignant tumors of the clival and prtroclival region[J].Int Arch Otorhinolaryngol,2014,18(Suppl 2):S157-S172.
[11] Kalwani N,Remenschneider AK,Faquin W,et al.Plas-macytoma of the Clivus Presenting as Bilateral Sixth Nerve Palsy[J].J Neurol Surg Rep,2015,76(1):e156-e159.
[12] Soutar R,Lucraft H,Jackson G,et al.Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma[J].Br J Haematol,2004,124(6):717-726.
[13] Schluterman KO,Fassas AB,Van Hemert RL,et al.Multiple myeloma invasion of the central nervous system[J].Arch Neurol,2004,61(9):1423-1429.
[14] 张忠,吴震,贾桂军,等.颅底浆细胞瘤的诊断和治疗[J].中华神经外科杂志,2010,26(12):1109-1112.
[15] Lee J,Kulubya E,Pressman BD,et al.Sellar and clival plasmacytomas:case series of 5patients with systematic review of 65published cases[J].Pituitary,2017,20(3):381-392.
[16] 吴佳栗,范国光.斜坡孤立性浆细胞瘤1例[J].医学影像学杂志,2018,28(4):537,541.
[17] 侯欣怡,高京生,高培毅.颅骨孤立性浆细胞瘤的影像学表现[J].放射学实践,2015(11):1099-1101.
[18] 袁箐,高培毅.颅底骨孤立性浆细胞瘤的CT和MRI诊断[J].实用放射学杂志,2009,25(10):1416-1419.
[19] 潘斌才,李斌,罗柏宁,等.颅底脊索样肿瘤的影像学与组织学鉴别诊断[J].中国现代神经疾病杂志,2013,13(7):611-619.
[20] 董帅,于德新,王青,等.斜坡脊索瘤的CT和MRI表现及误诊分析[J].实用放射学杂志,2018,34(9):1465-1467.
[21] 姜卫国,杨喜林,周韬.颅骨巨细胞瘤的CT诊断[J].中国医学影像技术,1998,14(9):651.
[22] 董立平,谢谦宇,夏宇.颅底骨巨细胞瘤的CT、MRI表现[J].中国中西医结合影像学杂志,2013,11(1):42-44.
[23] 曾雪明,马洪兵,周丹.恶性脑膜瘤的MRI诊断[J].实用放射学杂志,2018,34(2):184-186.