Kaufmann G A, Sundaram M, McDonald D J
Department of Radiology, St. Louis University Medical Center, Missouri 63110-0250.
Skeletal Radiol. 1991;20(6):413-8. doi: 10.1007/BF00191082.
Four patients with symptomatic Paget's disease of the appendicular skeleton were evaluated by magnetic resonance (MR) imaging. The plain film findings in each case were advanced but dissimilar. All patients had progressive symptoms of pain, and one presented with excruciating pain of short duration. The radiographic features included diffuse progressive osteolysis, cortical resorption, insufficiency fractures, bowing, and cortical and trabecular thickening. In three of the patients, MRI was performed to exclude sarcoma, revealing preservation of fatty marrow signal in all phases of Paget's disease except in patients with an acute fracture (demonstrated by MRI) and sarcoma. Small, focal, linear or oval areas of low signal seen against a background of normal marrow signal on short or long TR/TE do not mimic tumor. These findings suggest that fatty marrow signal is preserved in advanced Paget's disease unless an acute fracture or tumor is present.
对4例有症状的附肢骨骼佩吉特病患者进行了磁共振（MR）成像评估。每例患者的平片表现均为进展期但各不相同。所有患者均有进行性疼痛症状，1例患者出现持续时间短的剧痛。影像学特征包括弥漫性进行性骨质溶解、皮质吸收、应力性骨折、骨弯曲以及皮质和小梁增厚。3例患者进行了MRI检查以排除肉瘤，结果显示除急性骨折（MRI证实）和肉瘤患者外，佩吉特病各期均保留脂肪骨髓信号。在短TR/TE或长TR/TE序列上，在正常骨髓信号背景下可见的小的、局灶性、线性或椭圆形低信号区并非肿瘤表现。这些发现提示，除非存在急性骨折或肿瘤，否则进展期佩吉特病中脂肪骨髓信号得以保留。
