Lomasney L M, Martinez S, Demos T C, Harrelson J M
Department of Radiology, Loyola University Medical Center, Maywood, IL 60153, USA.
Skeletal Radiol. 1996 Apr;25(3):255-61. doi: 10.1007/s002560050075.
Multifocal vascular processes which arise in bone are a very inhomogeneous class of diseases. Four of these processes are derived from endothelial precursors, however, and share a similar radiographic spectrum. These four entities are reviewed in order to clarify their imaging patterns and the diagnostic utility of imaging modalities.
Eight cases of cystic angiomatosis, multifocal hemangioma, hemangioendothelioma and angiosarcoma presenting to a tertiary referral center over a 7-year period were reviewed. The medical literature was also reviewed for information concerning the imaging of these processes.
All four diseases produced radiolucent defects on plain radiographs with variable margination reflecting the aggressiveness of the lesions. Computed tomography was used to examine five patients and provided supportive, though generally non-diagnostic, information in the five cases in which it was performed. Radionuclide bone scintigraphy, as reported in the literature, underestimated the extent of skeletal involvement in all eight cases, though some lesions were identified. Radionuclide imaging with labeled red blood cells, performed in three cases, did not add any information, which is contrary to some reports in the literature. Magnetic resonance imaging proved the most sensitive for identifying lesions, although the imaging characteristics were not diagnostic.
Plain radiographs are the mainstay for imaging multifocal endothelial processes. Radiographs provide information on aggressiveness, multifocality and distribution of lesions. Computed tomography provides similar information. Magnetic resonance imaging often detects additional lesions. The insensitivity of radionuclide bone scintigraphy is surprising. Reports of unique deposition of radionuclide in tagged red blood cell scanning has been reported to support the diagnosis of vascular lesions, but it did not do so in these cases.
起源于骨骼的多灶性血管病变是一类非常不均一的疾病。然而，其中有四种病变起源于内皮前体细胞，并且具有相似的影像学表现。对这四种病变进行综述，以阐明其影像学特征及成像方式的诊断效用。
回顾了一家三级转诊中心7年间收治的8例囊性血管瘤病、多灶性血管瘤、血管内皮瘤和血管肉瘤病例。同时查阅医学文献以获取有关这些病变影像学表现的信息。
所有这四种疾病在X线平片上均表现为透亮缺损，其边缘情况各异，反映了病变的侵袭性。对5例患者进行了计算机断层扫描，在进行扫描的5例中提供了支持性信息，但通常不具有诊断性。正如文献报道，放射性核素骨闪烁扫描在所有8例中均低估了骨骼受累范围，不过还是发现了一些病变。对3例患者进行了标记红细胞的放射性核素成像，未提供任何额外信息，这与文献中的一些报道相悖。磁共振成像被证明是识别病变最敏感的方法，尽管其成像特征不具有诊断性。
X线平片是多灶性内皮病变成像的主要手段。X线平片可提供有关病变侵袭性、多灶性及分布的信息。计算机断层扫描提供类似信息。磁共振成像常能检测出更多病变。放射性核素骨闪烁扫描的不敏感性令人惊讶。文献报道标记红细胞扫描中放射性核素的独特沉积可支持血管病变的诊断，但在这些病例中并非如此。
