摘要:
Objective To analyse the bone eosinophilic granuloma plain radiographs and MRI performance and to discuss the misdiagnosis reason, and improve the correct diagnostic rate. Methods X-ray, MRI and clinical manifestations, preoperative di-agnosis of 43 patients with bone eosinophilic granuloma confirmed by biopsy/surgical pathology were analyzed retrospectively. Re-sults Of all patients performed by X-ray radiography, 6 cases were misdiagnoed for acute osteomyelitis, 3 for ewing sarcoma, 2 for chronic osteomyelitis, 2 for osteosarcoma, 2 for bone tuberculosis, 2 for lymphoma, 1 for osteofibrous dysplasia, 1 for bone cyst of the aneurysm, and 1 for enchondroma. The misdiagnoed rate was 51. 6%(16/31). Of 22 patients performed by MRI, 3 cases were misdiagnosis for osteomyelitis, 1 for Ewing's sarcoma, and 1 for lymphoma. The misdiagnosis rate was 22. 7%(5/22). Conclusion If we could ecognize the variability of the different parts of the lesions, different periods of the disease, and lesions in nature as the granuloma, reasonably choose imaging technology, carefully analyze the imaging signs of disease, closely combine with clinical and laboratory examination, the correct diagnostic rate would be improved.%目的 分析骨嗜酸性肉芽肿平片与MRI表现,探讨误诊原因,提高正确诊断率.方法 回顾分析经穿刺/手术病理证实的43例骨嗜酸性肉芽肿患者的X线、MRI及临床表现,术前术后诊断.结果 平片误诊为急性骨髓炎6例,尤因肉瘤3例,慢性骨髓炎、骨肉瘤、骨结核、淋巴瘤各2例,骨纤维结构不良、动脉瘤样骨囊肿、内生软骨瘤各1例,误诊率51.6%(16/31);MRI误诊为骨髓炎3例、Ewing肉瘤、淋巴瘤1例,误诊率为22.7%(5/22).结论 认识到本病不同部位、不同时期病变的多变性,而病变本质为肉芽肿,合理选择影像学技术,仔细分析病变的影像学征象,紧密结合临床及实验室检查,可提高本病正确诊断率.