骨骼肌肉系统疾病液液平面征课件

骨骼肌肉系统疾病一一液液平面征MusculoskeletallesionswithFluid-FluidleveD)Departmentofradiologythe2ndaffiliatedhospitalofSunyat-senuniversit骨骼肌肉系统疾病一一液1概述(overview)29%~11.2%的骨病变中可出现液-液平面。Prevalenceoffflinbonetumorsis2.9%11.2%T2W观察佳。MostconspicuousonT2W常与出血及肿瘤坏死有关。RelatedtopriorhemorrhageortumornecrosisCT上,各层CT值的不同形成了FFL。ThedifferenceinthedensityoftheselayerscanbeobservedonCTimagingMR上,各层信号上的差异形成了FFL。Thedifferenceinthesignalcharacteristicsoftheselayersallowforvisualizationofthefflonmri概述(overview)2单发FL(singleFFL):8;多发FFLs(MultipleFFLs:75非肿瘤良性benign恶性malignantnon-合计neoplastic(30%)22(67%)1(3%)13(59%)8(36%)1(5%2/32313(81%)3(19%)16entire结论:>2/3,大部分为良性病变单发FL(singleFFL):8;多发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病变的种类typiesofthelesion))骨病变动脉瘤样骨囊肿Aneurysma|BoneCyst,ABC单纯性骨囊肿SimpleBoneCyst骨纤维异常增殖症FibrousDysplasia骨内脂肪瘤intraosseousLipoma软骨母细胞瘤Chondroblastoma·毛细血管扩张型骨肉瘤TelangiectaticOsteosarcoma病变的种类6病变的种类(typiesofthelesion)(二)软组织病变血肿Hematoma肌间血管瘤IntramuscularHemangioma动静脉畸形Arteriovenousmalformation关节周围钙质沉着Periarticularcalcinosis软组织平滑肌瘤SoftTissueLeiomyoma肉瘤Sarcoma病变的种类7动脉瘤样骨囊肿(aneurysmalbonecyst,ABc)薄壁分隔、血性液体充盈多房房腔为特点的膨胀性骨病变。ABCisanexpansilelesioncontainingmixedmultiplethinwalled,bloodfilledcysticcavities创伤是引发该病的原因之一。Traumahasbeenindicatedasacause常伴发于其他骨病变。Oftenarisessecondarytopreexistinglesion好发年龄在5-20岁,长管状骨的干骺端多见,也可见于脊柱附件。Mostcommonlyoccurwithinthemetaphysisoflongtubularbones,buttheyarealsofoundwithintheposteriorelementsofthespine动脉瘤样骨囊肿8Imagingmanifestation偏心性膨胀性骨质破坏,常伴骨性分隔,甚者可呈气球样,病变内缘常完整。Eccentricosteolyticlesion,oftenwithseptations,thecorticalsurfaceexpandedorballooned,andtheinnermarginiswelldefinedMRl上,ABC常呈薄而完整的低信号边缘,病灶内信号不均房腔间信号可存在显著差异Athin,well-definedrimoflow-signalintensityabouttheABCiscommon.Thereisinhomogeneityofthesignalintensity,withindividuallobuleshavingmarkedlydifferentsignalcharacteristics85%可见液-液平面,常为多个液平,是ABC发展到中期或晚期阶段的典型表现。FFLscanbeseenin85%patientsandaretypicalofthemidorlatephaseofdevelopmentoftheABCImagingmanifestation9Imagingmanifestation16%的ABC可发生于骨表面,分为骨膜下型、骨皮质型及混合型。SixteenpercentofABCarisefromsurfaceofbones,includingsubperiosteal;corticalmixed骨膜下型ABC常具有侵袭性,可致周围软组织水肿,易误诊为毛细血管扩张型骨肉瘤。ABCsinsubperiosteallocationcandemonstrateaggressiveradiographicappearanceandedemaofadjacentsofttissuesmimickingtelangiectaticosteosarcomaImagingmanifestation10骨骼肌肉系统疾病液液平面征课件11骨骼肌肉系统疾病液液平面征课件12骨骼肌肉系统疾病液液平面征课件13骨骼肌肉系统疾病液液平面征课件14骨骼肌肉系统疾病液液平面征课件15骨骼肌肉系统疾病液液平面征课件16骨骼肌肉系统疾病液液平面征课件17骨骼肌肉系统疾病液液平面征课件18骨骼肌肉系统疾病液液平面征课件19骨骼肌肉系统疾病液液平面征课件20骨骼肌肉系统疾病液液平面征课件21骨骼肌肉系统疾病液液平面征课件22骨骼肌肉系统疾病液液平面征课件23骨骼肌肉系统疾病液液平面征课件24骨骼肌肉系统疾病液液平面征课件25骨骼肌肉系统疾病液液平面征课件26骨骼肌肉系统疾病液液平面征课件27骨骼肌肉系统疾病液液平面征课件28骨骼肌肉系统疾病液液平面征课件29骨骼肌肉系统疾病液液平面征课件30骨骼肌肉系统疾病液液平面征课件31骨骼肌肉系统疾病液液平面征课件32骨骼肌肉系统疾病液液平面征课件33骨骼肌肉系统疾病液液平面征课件34骨骼肌肉系统疾病液液平面征课件35骨骼肌肉系统疾病液液平面征课件36骨骼肌肉系统疾病液液平面征课件37骨骼肌肉系统疾病液液平面征课件38骨骼肌肉系统疾病液液平面征课件39骨骼肌肉系统疾病液液平面征课件40骨骼肌肉系统疾病液液平面征课件41骨骼肌肉系统疾病液液平面征课件42骨骼肌肉系统疾病液液平面征课件43骨骼肌肉系统疾病液液平面征课件44骨骼肌肉系统疾病液液平面征课件45骨骼肌肉系统疾病液液平面征课件46骨骼肌肉系统疾病液液平面征课件47骨骼肌肉系统疾病液