摘要
目的探讨儿童颅骨嗜酸性肉芽肿影像学分型及其临床意义。方法回顾性分析经病理证实的32例儿童颅骨嗜酸性肉芽肿(SEG)临床及影像学资料。根据肉芽肿大小、形态、颅骨破坏程度,将SEG分为肿块不明显型、肿块外凸型、肿块双凸型和肿块多发型。分析各型影像学特征,结合临床表现、治疗及预后等情况,探讨SEG影像学分型的临床意义。结果肿块不明显型3例(9.4%),表现为局灶性不全性骨质破坏,肉芽肿块形成不明显,行肉芽肿切除术,随访3例均无复发;肿块外凸型21例(65.6%),表现穿凿性骨质破坏以及明显外凸形肉芽肿块,采取肉芽肿切除并颅骨修补术,随访15例均无复发;肿块双凸型5例(15.6%):表现为穿凿性骨质破坏以及"双凸状"肿块,可累及硬脑膜并压迫脑实质,治疗以手术切除、颅骨修补及硬脑膜修补为主,随访3例均无复发;肿块多发型3例(9.4%),表现为多发程度不等的颅骨破坏和大小不等肉芽肿形成,治疗以手术加化疗为主,随访2例均有复发。结论儿童SEG影像学分型对SEG临床治疗方案的制定、预后判断等具有一定的指导意义。
Objective To explore the imaging typing of skull eosinophilic granuloma（SEG） in children, and the clinical significance of this typing system was determined. Methods The clinical and radiological data of 32 cases of SEG confirmed by pathology in the past six years were retrospectively reviewed. According to the imaging findings,which included the size and shape of the granuloma, and the degree of skull destruction, SEGs were divided into four types ： type I （ subtle granumoma）, type lI （ exteriorly convex granuloma） , type Ill （ biconvex granuloma） and type 1V （multiple granulomas and destructions）. The imaging features of different types of SEG were analyzed, and the signif- icance of imaging typing was explored combining with the clinical manifestations, treatment programs and prognosis. Results Three cases （9.4%） were included in type I ,in which,the granuloma was not obvious and the skull destruction was confined in the diploe and outer plate. In type I] （21 cases,65.6% ）, the imaging features included an obvious exteriorly convex mass and complete skull destruction of in- side and outside panels. Granuloma remove and destructed skull repair were performed in all cases,in which 15 were followed up and no re- currence was found. The imaging features of type 111 （5 cases, 15.6% ） were biconvex mass which broke through the inner plate and op- pressed the dura and cerebral parenchyma. Therapy program included not only surgical excision of the lesion but also repair of skull and dura. Three cases were followed up and no recurrence was found. Type IV （3 cases,9.4% ） showed multiple skull destructions and granulomas of various sizes. Chemotherapy and surgery treatment, poor prognosis and ease recurrence were characterized by this type. Conclusion we put forward a imaging typing method for SEGs. This typing system is helpful in guiding clinical protocols and prognosis of SEGs in children.
出处
《局解手术学杂志》
2014年第1期14-17,共4页
Journal of Regional Anatomy and Operative Surgery
