骨骼肌肉系統疾病一一液液平面征MusculoskeletallesionswithFluid-FluidleveD)Departmentofradiologythe2ndaffiliatedhospitalofSunyat-senuniversit骨骼肌肉系統疾病一一液1概述(overview)29%~11.2%的骨病變中可出現液-液平面。Prevalenceoffflinbonetumorsis2.9%11.2%T2W觀察佳。MostconspicuousonT2W常與出血及腫瘤壞死有關。RelatedtopriorhemorrhageortumornecrosisCT上,各層CT值的不同形成了FFL。ThedifferenceinthedensityoftheselayerscanbeobservedonCTimagingMR上,各層信號上的差異形成了FFL。Thedifferenceinthesignalcharacteristicsoftheselayersallowforvisualizationofthefflonmri概述(overview)2單發FL(singleFFL):8;多發FFLs(MultipleFFLs:75非腫瘤良性benign惡性malignantnon-合計neoplastic(30%)22(67%)1(3%)13(59%)8(36%)1(5%2/32313(81%)3(19%)16entire結論:>2/3,大部分為良性病變單發FL(singleFFL):8;多發FFLs(Mu31/3m13-2/3>2/3entire1/3m13-2/34Table1bonetumorsNo.SingleMultipleCavityMRISIonTI-WI+MRISIon<12>1/2FFLFFLAneurysmalbonecyst8Multiple,smallandlargeHypointenseHyperintenseMultiple,smallandlargeHy-andhyperintenseHyperintenseFibrousdysplasiaISingleHypointenseHyperintense+FibrousdisplaHypointenseOsteoblastomaMultiple,smallandlargeHypointenseHypernetSimplebonecystIMultiple,smallandlargeHyperintenseGiantcelltumorMultiple,smallHypointenseHyperinterTable2SofttissuetumersNo.SngleFFLMultipleFFLCavityMRSIonTI-WIMRSIonT2-WI<1/2>1/2(difluse)Synovialsarcoma3Multiple,smallandlargeHyperintenseHyperintenseABCofsolitissueIMultiple,smallandlargeHypointenseHyperintenseMyxofibrosarcomaISingle,largeHyperintenseHyperintense+SarcomanosHyperintenseH,Table1bonetumors5病變的種類typiesofthelesion))骨病變動脈瘤樣骨囊腫Aneurysma|BoneCyst,ABC單純性骨囊腫SimpleBoneCyst骨纖維異常增殖癥FibrousDysplasia骨內脂肪瘤intraosseousLipoma軟骨母細胞瘤Chondroblastoma·毛細血管擴張型骨肉瘤TelangiectaticOsteosarcoma病變的種類6病變的種類(typiesofthelesion)(二)軟組織病變血腫Hematoma肌間血管瘤IntramuscularHemangioma動靜脈畸形Arteriovenousmalformation關節周圍鈣質沉著Periarticularcalcinosis軟組織平滑肌瘤SoftTissueLeiomyoma肉瘤Sarcoma病變的種類7動脈瘤樣骨囊腫(aneurysmalbonecyst,ABc)薄壁分隔、血性液體充盈多房房腔為特點的膨脹性骨病變。ABCisanexpansilelesioncontainingmixedmultiplethinwalled,bloodfilledcysticcavities創傷是引發該病的原因之一。Traumahasbeenindicatedasacause常伴發于其他骨病變。Oftenarisessecondarytopreexistinglesion好發年齡在5-20歲,長管狀骨的干骺端多見,也可見于脊柱附件。Mostcommonlyoccurwithinthemetaphysisoflongtubularbones,buttheyarealsofoundwithintheposteriorelementsofthespine動脈瘤樣骨囊腫8Imagingmanifestation偏心性膨脹性骨質破壞,常伴骨性分隔,甚者可呈氣球樣,病變內緣常完整。Eccentricosteolyticlesion,oftenwithseptations,thecorticalsurfaceexpandedorballooned,andtheinnermarginiswelldefinedMRl上,ABC常呈薄而完整的低信號邊緣,病灶內信號不均房腔間信號可存在顯著差異Athin,well-definedrimoflow-signalintensityabouttheABCiscommon.Thereisinhomogeneityofthesignalintensity,withindividuallobuleshavingmarkedlydifferentsignalcharacteristics85%可見液-液平面,常為多個液平,是ABC發展到中期或晚期階段的典型表現。FFLscanbeseenin85%patientsandaretypicalofthemidorlatephaseofdevelopmentoftheABCImagingmanifestation9Imagingmanifestation16%的ABC可發生于骨表面,分為骨膜下型、骨皮質型及混合型。SixteenpercentofABCarisefromsurfaceofbones,includingsubperiosteal;corticalmixed骨膜下型ABC常具有侵襲性,可致周圍軟組織水腫,易誤診為毛細血管擴張型骨肉瘤。ABCsinsubperiosteallocationcandemonstrateaggressiveradiographicappearanceandedemaofadjacentsofttissuesmimickingtelangiectaticosteosarcomaImagingmanifestation10骨骼肌肉系統疾病液液平面征課件11骨骼肌肉系統疾病液液平面征課件12骨骼肌肉系統疾病液液平面征課件13骨骼肌肉系統疾病液液平面征課件14骨骼肌肉系統疾病液液平面征課件15骨骼肌肉系統疾病液液平面征課件16骨骼肌肉系統疾病液液平面征課件17骨骼肌肉系統疾病液液平面征課件18骨骼肌肉系統疾病液液平面征課件19骨骼肌肉系統疾病液液平面征課件20骨骼肌肉系統疾病液液平面征課件21骨骼肌肉系統疾病液液平面征課件22骨骼肌肉系統疾病液液平面征課件23骨骼肌肉系統疾病液液平面征課件24骨骼肌肉系統疾病液液平面征課件25骨骼肌肉系統疾病液液平面征課件26骨骼肌肉系統疾病液液平面征課件27骨骼肌肉系統疾病液液平面征課件28骨骼肌肉系統疾病液液平面征課件29骨骼肌肉系統疾病液液平面征課件30骨骼肌肉系統疾病液液平面征課件31骨骼肌肉系統疾病液液平面征課件32骨骼肌肉系統疾病液液平面征課件33骨骼肌肉系統疾病液液平面征課件34骨骼肌肉系統疾病液液平面征課件35骨骼肌肉系統疾病液液平面征課件36骨骼肌肉系統疾病液液平面征課件37骨骼肌肉系統疾病液液平面征課件38骨骼肌肉系統疾病液液平面征課件39骨骼肌肉系統疾病液液平面征課件40骨骼肌肉系統疾病液液平面征課件41骨骼肌肉系統疾病液液平面征課件42骨骼肌肉系統疾病液液平面征課件43骨骼肌肉系統疾病液液平面征課件44骨骼肌肉系統疾病液液平面征課件45骨骼肌肉系統疾病液液平面征課件46骨骼肌肉系統疾病液液平面征課件47骨骼肌肉系統疾病液液平面征課件48骨骼肌肉系統疾病液液平面征課件49骨骼肌肉系統疾病液液平面征課件50骨骼肌肉系統疾病液液平面征課件51骨骼肌肉系統疾病液液平面征課件52骨骼肌肉系統疾病液液平面征課件53骨骼肌肉系統疾病液液平面征課件54骨骼肌肉系統疾病液液平面征課件55骨骼肌肉系統疾病液液平面征課件56骨骼肌肉系統疾病液液平面征課件57骨骼肌肉系統疾病液液平面征課件58骨骼肌肉系統疾病液液平面征課件59骨骼肌肉系統疾病一一液液平面征MusculoskeletallesionswithFluid-FluidleveD)Departmentofradiologythe2ndaffiliatedhospitalofSunyat-senuniversit骨骼肌肉系統疾病一一液60概述(overview)29%~11.2%的骨病變中可出現液-液平面。Prevalenceoffflinbonetumorsis2.9%11.2%T2W觀察佳。MostconspicuousonT2W常與出血及腫瘤壞死有關。RelatedtopriorhemorrhageortumornecrosisCT上,各層CT值的不同形成了FFL。ThedifferenceinthedensityoftheselayerscanbeobservedonCTimagingMR上,各層信號上的差異形成了FFL。Thedifferenceinthesignalcharacteristicsoftheselayersallowforvisualizationofthefflonmri概述(overview)61單發FL(singleFFL):8;多發FFLs(MultipleFFLs:75非腫瘤良性benign惡性malignantnon-合計neoplastic(30%)22(67%)1(3%)13(59%)8(36%)1(5%2/32313(81%)3(19%)16entire結論:>2/3,大部分為良性病變單發FL(singleFFL):8;多發FFLs(Mu621/3m13-2/3>2/3entire1/3m13-2/363Table1bonetumorsNo.SingleMultipleCavityMRISIonTI-WI+MRISIon<12>1/2FFLFFLAneurysmalbonecyst8Multiple,smallandlargeHypointenseHyperintenseMultiple,smallandlargeHy-andhyperintenseHyperintenseFibrousdysplasiaISingleHypointenseHyperintense+FibrousdisplaHypointenseOsteoblastomaMultiple,smallandlargeHypointenseHypernetSimplebonecystIMultiple,smallandlargeHyperintenseGiantcelltumorMultiple,smallHypointenseHyperinterTable2SofttissuetumersNo.SngleFFLMultipleFFLCavityMRSIonTI-WIMRSIonT2-WI<1/2>1/2(difluse)Synovialsarcoma3Multiple,smallandlargeHyperintenseHyperintenseABCofsolitissueIMultiple,smallandlargeHypointenseHyperintenseMyxofibrosarcomaISingle,largeHyperintenseHyperintense+SarcomanosHyperintenseH,Table1bonetumors64病變的種類typiesofthelesion))骨病變動脈瘤樣骨囊腫Aneurysma|BoneCyst,ABC單純性骨囊腫SimpleBoneCyst骨纖維異常增殖癥FibrousDysplasia骨內脂肪瘤intraosseousLipoma軟骨母細胞瘤Chondroblastoma·毛細血管擴張型骨肉瘤TelangiectaticOsteosarcoma病變的種類65病變的種類(typiesofthelesion)(二)軟組織病變血腫Hematoma肌間血管瘤IntramuscularHemangioma動靜脈畸形Arteriovenousmalformation關節周圍鈣質沉著Periarticularcalcinosis軟組織平滑肌瘤SoftTissueLeiomyoma肉瘤Sarcoma病變的種類66動脈瘤樣骨囊腫(aneurysmalbonecyst,ABc)薄壁分隔、血性液體充盈多房房腔為特點的膨脹性骨病變。ABCisanexpansilelesioncontainingmixedmultiplethinwalled,bloodfilledcysticcavities創傷是引發該病的原因之一。Traumahasbeenindicatedasacause常伴發于其他骨病變。Oftenarisessecondarytopreexistinglesion好發年齡在5-20歲,長管狀骨的干骺端多見,也可見于脊柱附件。Mostcommonlyoccurwithinthemetaphysisoflongtubularbones,buttheyarealsofoundwithintheposteriorelementsofthespine動脈瘤樣骨囊腫67Imagingmanifestation偏心性膨脹性骨質破壞,常伴骨性分隔,甚者可呈氣球樣,病變內緣常完整。Eccentricosteolyticlesion,oftenwithseptations,thecorticalsurfaceexpandedorballooned,andtheinnermarginiswelldefinedMRl上,ABC常呈薄而完整的低信號邊緣,病灶內信號不均房腔間信號可存在顯著差異Athin,well-definedrimoflow-signalintensityabouttheABCiscommon.Thereisinhomogeneityofthesignalintensity,withindividuallobuleshavingmarkedlydifferentsignalcharacteristics85%可見液-液平面,常為多個液平,是ABC發展到中期或晚期階段的典型表現。FFLscanbeseenin85%patientsandaretypicalofthemidorlatephaseofdevelopmentoftheABCImagingmanifestation68Imagingmanifestation16%的ABC可發生于骨表面,分為骨膜下型、骨皮質型及混合型。SixteenpercentofABCarisefromsurfaceofbones,includingsubperiosteal;corticalmixed骨膜下型ABC常具有侵襲性,可致周圍軟組織水腫,易誤診為毛細血管擴張型骨肉瘤。ABCsinsubperiosteallocationcandemonstrateaggressiveradiographicappearanceandedemaofadjacentsofttissuesmimickingtelangiectaticosteosarcomaImagingmanifestation69骨骼肌肉系統疾病液液平面征課件70骨骼肌肉系統疾病液液平面征課件71骨骼肌肉系統疾病液液平面征課件72骨骼肌肉系統疾病液液平面