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Focal nodular marrow hyperplasia: Imaging features of 53 cases.

局灶性结节样骨髓增生: 53例影像学特点。

  • 影响因子:2.12
  • DOI:10.1259/bjr.20200206
  • 作者列表:"Rajakulasingam R","Saifuddin A
  • 发表时间:2020-08-01
Abstract

OBJECTIVE:To describe the characteristic imaging features of focal nodular marrow hyperplasia (FNMH). METHODS AND MATERIALS:Retrospective review of all patients with a diagnosis of FNMH between January 2007 and September 2019. RESULTS:The study included 53 patients, 7 males and 46 females with a mean age of 58 years (range 12-95 years). All had MRI with conventional spin echo sequences showing a poorly defined round/oval lesion with mild T1W iso/hyperintensity compared to skeletal muscle, low T2W turbo spin echo (TSE) signal intensity (SI) compared to marrow fat and variable SI on STIR, but never associated with reactive marrow oedema. All 53 patients had follow-up MRI, with all lesions remaining stable or partially resolving. In-phase (IP) and out-of-phase (OP) chemical shift imaging (CSI) was obtained in 31 of these, with 28 (90.3%) showing >20% SI drop on the OP sequence, while 3 (9.7%) demonstrated <20% SI drop. CT was available in 26 cases, 17 (65.4%) showing mild medullary sclerosis. Single-photon emission computed tomography CT (SPECT-CT) was available in four cases and Flourodeoxyglucose positron emission tomography CT (FDG PET-CT) in 2, all showing increased uptake. Focal uptake was also seen in three of eight patients who had undergone whole body bone scintigraphy. Only one lesion was biopsied, confirming FNMH. CONCLUSION:The imaging appearances of FNMH have been described on various modalities, particularly MRI with emphasis on the role of IP and OP CSI typically demonstrating >20% SI reduction. FNMH should be recognised and treated as a 'do not touch' lesion which does not require biopsy or prolonged follow-up. ADVANCES IN KNOWLEDGE:We describe and clarify the imaging characteristics of FNMH on MRI, including CSI, CT and various nuclear medicine modalities. An imaging algorithm is suggested for allowing a non-invasive diagnosis.

摘要

目的: 探讨局灶性结节性骨髓增生 (FNMH) 的影像学特征。 方法和材料: 回顾性分析2007年1月至2019年9月间诊断为FNMH的所有患者。 结果: 该研究包括53名患者,7名男性和46名女性,平均年龄为58岁 (范围12-95岁)。所有MRI均具有常规自旋回波序列,显示与骨骼肌相比,具有轻度T1W iso/高强度的圆形/椭圆形病变,与骨髓脂肪相比,具有低T2W turbo自旋回波 (TSE) 信号强度 (SI),并且在STIR上具有可变SI,但从未与反应性骨髓水肿相关。所有53例患者均进行了MRI随访,所有病灶保持稳定或部分消退。在其中31个中获得了同相 (IP) 和异相 (OP) 化学位移成像 (CSI),其中28个 (90.3%) 在OP序列上显示> 20% 的SI下降,而3个 (9.7%) 显示 <20% 的SI下降。26例有CT表现,17例 (65.4%) 表现为轻度髓质硬化。单光子发射计算机断层扫描CT (spect-ct) 4例,氟脱氧葡萄糖正电子发射断层扫描CT (FDG pet-ct) 2例,均显示摄取增加。8例接受全身骨显像的患者中,有3例还出现局灶性摄取。仅对一个病灶进行活检,证实为FNMH。 结论: FNMH的影像学表现已在各种模式下描述,特别是MRI,重点是IP和OP CSI的作用,通常显示> 20% SI减少。FNMH应被认为是不需要活检或长期随访的 “请勿触摸” 病变。 知识进展: 我们描述并阐明了FNMH在MRI上的成像特征,包括CSI,CT和各种核医学模式。提出了一种用于允许非侵入性诊断的成像算法。

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影响因子:2.36
发表时间:2020-01-01
来源期刊:Platelets
DOI:10.1080/09537104.2019.1581922
作者列表:["Szanto T","Nummi V","Jouppila A","Brinkman HJM","Lassila R"]

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