From the Division of Musculoskeletal Imaging, Department of Radiology, New York University School of Medicine, Center for Biomedical Imaging, 660 First Ave, Room 223, New York, NY 10016 (I.K., E.F.A., C.J.B.); Department of Radiology, Scottish Rite Hospital for Children, Dallas, Tex (H.A.); Division of Musculoskeletal Imaging and Intervention, Department of Radiology, University of Washington, Seattle, Wash (M.C.); Division of Neuroradiology, Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (S.E.S.); and Division of Musculoskeletal Radiology, Department of Radiology, Rutgers University Hospital, Newark, NJ (C.W.).
Radiographics. 2021 Jul-Aug;41(4):1144-1163. doi: 10.1148/rg.2021200198.
Calvarial abnormalities are usually discovered incidentally on radiologic studies or less commonly manifest with symptoms. This narrative review describes the imaging spectrum of the abnormal calvaria. The extent, multiplicity, and other imaging features of calvarial abnormalities can be combined with the clinical information to establish a final diagnosis or at least narrow the differential considerations. Prior trauma (congenital depression, leptomeningeal cysts, posttraumatic osteolysis), surgical intervention (flap osteonecrosis and burr holes), infection, and inflammatory processes (sarcoidosis) can result in focal bone loss, which may also be seen with idiopathic disorders without (bilateral parietal thinning and Gorham disease) or with (Parry-Romberg syndrome) atrophy of the overlying soft tissues. Anatomic variants (arachnoid granulations, venous lakes, parietal foramina) and certain congenital lesions (epidermoid and dermoid cysts, atretic encephalocele, sinus pericranii, and aplasia cutis congenita) manifest as solitary lytic lesions. Other congenital entities (lacunar skull and dysplasia) display a diffuse pattern of skull involvement. Several benign and malignant primary bone tumors involve the calvaria and manifest as lytic, sclerotic, mixed lytic and sclerotic, or thinning lesions, whereas multifocal disease is mainly due to hematologic or secondary malignancies. Metabolic disorders such as rickets, hyperparathyroidism, renal osteodystrophy, acromegaly, and Paget disease involve the calvaria in a more diffuse pattern. RSNA, 2021.
颅骨异常通常在影像学研究中偶然发现，或较少出现症状。本叙述性综述描述了颅骨异常的影像学表现。颅骨异常的范围、多发性和其他影像学特征可以与临床信息相结合，以确立最终诊断，或至少缩小鉴别诊断的考虑范围。既往外伤（先天性凹陷、软脑膜囊肿、创伤后骨溶解）、手术干预（皮瓣骨坏死和骨钻孔）、感染和炎症过程（结节病）可导致局灶性骨丢失，也可见于特发性疾病，无（双侧顶骨变薄和 Gorham 病）或有（Parry-Romberg 综合征）软组织萎缩。解剖变异（蛛网膜颗粒、静脉湖、顶骨孔）和某些先天性病变（表皮样囊肿和皮样囊肿、萎缩性脑膨出、颅骨板障静脉窦和先天性皮肤发育不全）表现为单发溶骨性病变。其他先天性病变（腔隙性颅骨和发育不良）表现为颅骨弥漫性受累。几种良性和恶性原发性骨肿瘤累及颅骨，表现为溶骨性、硬化性、混合溶骨性和硬化性或变薄病变，而多灶性疾病主要是由于血液系统或继发性恶性肿瘤引起的。代谢性疾病，如佝偻病、甲状旁腺功能亢进、肾性骨营养不良、肢端肥大症和 Paget 病，以更弥漫的方式累及颅骨。RSNA，2021 年。
