【摘要】 目的 分析骨嗜酸性肉芽肿的误诊原因，以期提高本病的诊断水平。方法 回顾性分析经病理证实的29例骨嗜酸性肉芽肿误诊病例的临床和影像学资料，其中X线平片29例，CT 12例，MRI 10例。结果 误诊为尤文肉瘤8例，其他原发性骨恶性肿瘤4例，骨转移瘤5例，骨髓炎7例，骨结核3例，骨囊肿2例。误诊的主要原因：对骨嗜酸性肉芽肿缺乏认识占75.9%( 22/29 )；不恰当地应用影像学检查手段占44.8%(13/29)；诊断思维偏差占82.8%(24/29)。结论 加深对骨嗜酸性肉芽肿影像学表现的认识，正确有效地应用影像学的检查手段，培养正确的诊断思维并结合临床，大多数骨嗜酸性肉芽肿病例能在治疗前做出正确诊断。

    【关键词】 嗜酸性肉芽肿；骨骼；误诊

    Eosinophilic granuloma of bone: an analysis of misdiagnosis in 29 cases

    GUO Yan,FENG Shi-ting,ZHANG Ling,et al.

    Department of Radiology,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China

    【Abstract】 Objective To analyze the cause of misdiagnosis of eosinophilic granuloma of bone so as to improve diagnosis accuracy of the disease.Methods The clinical data and radiological images of 29 cases of eosinophilic granuloma of bone,misdiagnosed initially and eventually proved by pathology,were studied retrospectively.Plain films were obtained in all 29 cases,CT scan was performed in 12 cases,and MRI was done in 10 cases.Results The eosinophilic granuloma of bone was misdiagnosed as Ewing′s sarcoma in 8 cases; as primary malignancy of bone in 4 cases; as metastatic lesions of bone in 5 cases; as osteomyelitis in 7 cases; as bone tuberculosis in 3 cases; and as bone cyst in 2 cases.The major factors leading to misdiagnosis were: lack of understanding of eosinophilic granuloma of bone in 75.9% (22/29) cases,improper utilization of imaging modalities in 44.8%(13/29)cases; deviated strategies of diagnosis in 82.8%(24/29)cases.Conclusion By making a further understanding of imaging findings of eosinophilic granuloma of bone,applying suitable imaging modalities,following the right approach of diagnosis,and integrating the clinical data,accurate diagnosis is accessible in most cases of eosinophilic granuloma of bone before the decisions of treatment is made. ......