| 夏同敬,郑田淑,杨文江,夏天祥.截瘫后骨化性肌炎影像学表现[J].中国医学影像技术,2024,40(11):1760~1763 |
| 截瘫后骨化性肌炎影像学表现 |
| Imaging manifestations of postparaplegic myositis ossificans |
| 投稿时间：2024-05-11 修订日期：2024-07-10 |
| DOI：10.13929/j.issn.1003-3289.2024.11.026 |
| 中文关键词: 骨化性肌炎 截瘫 诊断显像 |
| 英文关键词:myositis ossificans paraplegia diagnostic imaging |
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| 中文摘要: |
| 目的 观察截瘫后骨化性肌炎(PPMO)影像学表现。方法 回顾性收集14例临床诊断PPMO,均接受病变部位X线检查,其中9例接受CT、4例接受MR检查;分析PPMO影像学表现并进行分期。结果 14例中,病变位于双侧髋关节8例、单侧髋关节周围软组织3例、双侧大腿2例、双侧小腿1例;其中早期4例、中期3例、晚期7例。X线片显示4例早期病变表现为软组织肿胀,内见云絮状高密度骨化影,边缘模糊;3例中期病变表现为斑片状、条索状高密度骨化影,密度不均,边缘清;7例晚期病变表现为大片状、条带状高密度骨化影,与骨干及肌肉长轴走行一致,边缘清晰。CT显示1例早期PPMO表现为软组织肿胀,内见云絮状较高密度骨化影;2例中期PPMO表现为斑片状高密度骨化影,密度不均,局部呈蛋壳样改变,典型者呈同心圆表现,边缘清晰;6例晚期PPMO表现为大片状、条索状高密度骨化病灶,内部为不均匀低密度,呈骨髓髓腔样改变,边缘密度增高呈骨皮质状改变。MRI显示1例早期PPMO表现为软组织肿胀呈低T1WI、高T2WI信号,边缘模糊,呈羽毛状改变;1例中期PPMO病变T1WI呈等或略低信号,T2WI呈不均匀高信号,信号强度高于周围肌肉组织,呈分层带状表现,病灶周围软组织及邻近骨髓呈低T1、高T2水肿信号;2例晚期病变T1WI呈等-低信号、T2WI不均匀高信号,边缘骨皮质改变呈低信号,周围软组织水肿。结论 PPMO影像学表现具有一定特征性。 |
| 英文摘要: |
| Objective To observe imaging manifestations of postparaplegic myositis ossificans (PPMO). Methods A total of 14 patients with clinically diagnosed PPMO who underwent X-ray examination of the lesion sites were retrospectively collected, among them 9 cases underwent CT and 4 cases underwent MR examination. Imaging manifestations of PPMO lesions were analyzed and staged. Results Among 14 cases, PPMO lesions located in soft tissue around bilateral hip joint in 8 cases, in soft tissue around unilateral hip joint in 3 cases, in bilateral thigh in 2 cases and in bilateral calf in 1 case. Early stage PPMO was assessed in 4 cases, while middle stage in 3 and late stage PPMO in 7 cases. X-ray films showed early stage PPMO represented as swelled soft tissue, with cloud flocculent high density ossification shadows and blurred edges in 4 cases. In 3 cases of middle stage PPMO, X-ray films showed patchy, strip-like high density ossification shadow with uneven density and clear edges. Lesions in 7 cases of late stage PPMO presented as large flake, banded high-density ossification shadow consistent to the long axis of backbone and muscle with clear edges on X-ray films. One case of early stage PPMO was characterized by swelled soft tissue and high density ossification shadow on CT, while 2 cases of middle stage PPMO showed patchy high-density ossification shadow with uneven density and local eggshell-like changes, and the typical lesions had concentric circle appearance with clear edges. Six cases of late stage PPMO showed large lamellar, cord-like high-density ossification lesions with uneven and low internal densities, myeloid cavity changes and increased marginal density presented as cortical-like changes on CT. On MRI, 1 case of early stage PPMO was characterized by swelled soft tissue with long T1 and long T2 signals, blurred edges and feathery changes. One case of middle stage PPMO showed equal or slightly low signal on T1WI, uneven high signal on T2WI, and the signal intensities were higher than the surrounding muscle with stratifications, while the surrounding soft tissue and adjacent bone marrow showed low T1WI and high T2WI edema signals. Two cases of late stage PPMO showed equal and low signals on T1WI, uneven high signals on T2WI, cortical changes presented as low signals on the margin, and edema signals were found in the surrounding soft tissue. Conclusion Imaging manifestations of PPMO had certain characteristics. |
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