目的 探讨动脉瘤样骨囊肿的影像学表现,提高对动脉瘤样骨囊肿的诊断水平.方法 收集19例经手术病理证实的动脉瘤样骨囊肿的X线、CT和MRI表现,14例经X线检查,4例经CT检查,7例经MRI检查.结果 发生于股骨上段8例,肱骨中上段3例,胫骨上段和髂骨各2例,腓骨小头、下颌骨、颧骨和跟骨各1例;X线表现为囊状骨质破坏,周边有薄层骨质增生硬化,内部可见骨嵴和骨性分隔,骨皮质膨胀变薄,可合并病理性骨折,X线平片诊断正确率为35.7%;CT表现为囊状膨胀性骨质破坏,周围可见骨壳,内部密度不均匀,可见骨性分隔,病灶可向软组织内突出;MRI表现为膨胀性多囊状病灶,周边见低信号环,囊内可见液-液平,T1WI增强扫描囊壁和分隔呈薄层环形强化,MRI 诊断正确率为71.4%.结论 MRI较X线平片、CT具有更高的诊断价值,三者结合,有助于ABC的定性诊断.%Objective To approach the imaging features of X-Ray, CT and MRI in the diagnosis of aneurysmal bone cyst and to improve the diagnosis level of aneurysmal bone cyst. Methods Imaging data of 53 patients with aneurysmal bone cyst proved by pathology were reviewed.14 patients were examined by radiography, 4 patients were examined by CT, and 7 patients were examined by MRI. Results The radiographic appearances of aneurysmal bone cyst were showed cystic bone destruction surrounded by a rim of lamellar bone sclerosis, bone cristae and septations in the lesion, expansive and tenuis bone cortex and pathologic fracture of bone. The correct rate of radiography was 35.7%. The CT appearances of aneurysmal bone cyst were showed cystic expansive bone destruction surrounded by bone shell, uneven density in the lesion with bone septations and local lesion protruded to soft tissue. The MRI appearances of aneurysmal bone cyst were showed expansile lesion consisting of multiple cystic spaces lined by a rim of low signal intensity, multiple fluid levels in cystic cavities and enhancement of cyst walls and internal septations in contrast-enhanced T1-weighted sequences. The correct rate of MRI was 71.4%. Conclusion MRI was more valuable than radiography or CT in diagnosis of aneurysmal bone cyst. Combining of radiography, CT and MRI was benefit to qualitative diagnosis of aneurysmal bone cyst.
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