CAJ | 학술논문

目的探讨手部掌指骨与四肢长骨原发血管瘤的影像、临床及病理特征.方法回顾性分析经手术后病理检查证实的9例掌指骨及8例四肢长骨血管瘤的影像和临床资料,并结合文献进行对比分析.17例均行X线检查,2例行CT检查,1例行MR[检查.结果 9例掌指骨血管瘤中髓型7例、骨膜型1例、皮质内型1例.8例四肢长骨血管瘤中髓型6例、骨膜型1例、皮质内型1例.髓型在掌指骨X线片显示为网格状骨纹,略膨胀;在长骨表现多样,可呈囊状、网格状或溶骨性改变.骨膜型在掌指骨及长骨X线片表现类似,均为皮质不规则增厚、硬化,及放射状骨膜新生骨.皮质内型在掌指骨及长骨X线片均表现为边界清晰的骨质破坏区,边缘轻度硬化;1例指骨皮质内型血管瘤的MRI表现为稍长T1WI,长T2WI信号,并夹杂少许低信号,病灶突破骨皮质,形成软组织肿块,邻近软组织内见迂曲血管影.结论手部掌指骨及四肢长骨原发血管瘤的影像学表现较为相近,但长骨血管瘤表现更为丰富,典型表现均为网格状或囊状骨质破坏.影像学检查有助于显示病灶范围及周围肌肉侵犯情况,为临床诊疗及后期功能评估提供支持.
목적 탐토수부장지골여사지장골원발혈관류적영상、림상급병리특정.방법 회고성분석경수술후병리검사증실적9례장지골급8례사지장골혈관류적영상화림상자료,병결합문헌진행대비분석.17례균행X선검사,2례행CT검사,1례행MR[검사.결과 9례장지골혈관류중수형7례、골막형1례、피질내형1례.8례사지장골혈관류중수형6례、골막형1례、피질내형1례.수형재장지골X선편현시위망격상골문,략팽창;재장골표현다양,가정낭상、망격상혹용골성개변.골막형재장지골급장골X선편표현유사,균위피질불규칙증후、경화,급방사상골막신생골.피질내형재장지골급장골X선편균표현위변계청석적골질파배구,변연경도경화;1례지골피질내형혈관류적MRI표현위초장T1WI,장T2WI신호,병협잡소허저신호,병조돌파골피질,형성연조직종괴,린근연조직내견우곡혈관영.결론 수부장지골급사지장골원발혈관류적영상학표현교위상근,단장골혈관류표현경위봉부,전형표현균위망격상혹낭상골질파배.영상학검사유조우현시병조범위급주위기육침범정황,위림상진료급후기공능평고제공지지.
Objective To study the radiologic,clinical and pathologic characteristics and diagnostie methods of primary bone hemangioma in the hand and long bones.Methods A retrospective review was conducted of 17 histologically confirmed primary bone hemangioma cases.Nine cases affected the hand while the other 8 cases the long bones of the extremities.The clinical,radiologic and pathologic characteristics were further analyzed and compared with those reported the literature.All 17 patients were examined with X-ray,while 2 patients had CT and 1 patient had MRI.Results Metacarpal and phalangeal hemangioma occurred in the bone marrow in 7 cases,in the periosteum in 1 case,and in the cortex in 1 case.Long bone hemangioma occurred in the bone marrow in 6 cases,in the periosteum in 1 case,and within the cortex in 1 case.When it occurred in the bone marrow cavity of metacarpals or phalanges,X-ray showed grid-like bone pattern and slight enlargement of the bone.When bone marrow of the long bones was affected,radiologic manifestations varied from cystic,gidlike to osteolytic changes.Similar X-ray findings were seen when hemangioma affected the periosteum of long bones and the metacarpals and phalanges,which included irregular cortical thickening,hardening,and radiating periosteal new bone formation.Lesions occurred in the cortex of metacarpals and phalanges and of long bones had similar X-ray characteristics:clearly demarcated bone destruction with slightly hardened edge.The MRI findings of hemangioma in the phalangeal cortex of 1 case showed longer T1WI signals and long T2WI signals mixed with a little low signal.The lesion penetrated the cortex and formed a soft tissue mass.Winding vascular sign could been seen in the adjacent soft tissues.Conclusion Imaging findings of primary hemangioma in metacarpals,phalanges and long bones are similar.Radiologic characteristics of long bone hemangiomas are more diverse,the typical ones being grid-like or cystic bone destruction.Imaging studies help to show the range of lesions and the extent of surroumding muscle involvement,providing support for clinical diagnosis and later functional evaluation.