Zhang Yan, Sun Xiaoli, Shen Wenbin, Hao Kun, Hao Qi, Li Xingpeng, Wang Rengui
Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Department of Lymph Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Quant Imaging Med Surg. 2022 Sep;12(9):4549-4558. doi: 10.21037/qims-21-1202.
Few studies have focused on the morphology of systematic lymphatic abnormality-related osseous lesions. In this study, we classified systematic lymphatic abnormality-related osseous lesions into four types based on their morphology and density. We also discussed the imaging features of computed tomography lymphangiography (CTL) in this disease.
In this retrospective cohort study, the clinical and imaging data of 39 patients with systematic lymphatic abnormality-related osseous lesions were collected. All patients underwent computed tomography (CT) scans of the chest and abdomen after direct lymphangiography, and two experienced radiologists evaluated the CTL features of intraosseous and extraosseous lymphatic vessel abnormalities.
Intraosseous osteolytic changes were observed in all 39 patients. According to the morphological density of the lesions, systematic lymphatic abnormality-related osseous lesions were classified into four types: cyst-like (76.9%), canal-like or honeycomb-like (87.2%), osteoporosis-like (41.0%), and osteosclerosis-like (20.5%), with abnormal deposits of lipiodol seen in the first two types. Enhanced CT of the thorax and abdomen was performed in 11 cases, and enhancement was not seen in any intraosseous lesions.
The CTL features of systematic lymphatic abnormality-related osseous lesions have specific characteristics and are often accompanied by extraosseous abnormalities, which can provide a vital imaging basis for the diagnosis and differentiation of this disease.
很少有研究关注系统性淋巴管异常相关骨病变的形态学。在本研究中,我们根据系统性淋巴管异常相关骨病变的形态和密度将其分为四种类型。我们还讨论了计算机断层扫描淋巴管造影(CTL)在该疾病中的影像学特征。
在这项回顾性队列研究中,收集了39例系统性淋巴管异常相关骨病变患者的临床和影像学数据。所有患者在直接淋巴管造影后均接受了胸部和腹部的计算机断层扫描(CT),两名经验丰富的放射科医生评估了骨内和骨外淋巴管异常的CTL特征。
39例患者均观察到骨内溶骨性改变。根据病变的形态密度,系统性淋巴管异常相关骨病变分为四种类型:囊肿样(76.9%)、管样或蜂窝样(87.2%)、骨质疏松样(41.0%)和骨硬化样(20.5%),前两种类型可见碘油异常沉积。11例患者进行了胸部和腹部增强CT检查,骨内病变均未见强化。
系统性淋巴管异常相关骨病变的CTL特征具有特异性,且常伴有骨外异常,可为该疾病的诊断和鉴别提供重要的影像学依据。