장관골에 발생한 골내지방종의 영상의학적 소견 = Radiologic Findings of Intraosseous Lipoma of Long Bones

다국어 초록 (Multilingual Abstract)

Purpose: To investigate radiologic findings of intraosseous lipoma on plain radiograph and magnetic resonance imaging (MRI).
Materials and Methods: Twenty-seven radiologically or pathologically confirmed intraosseous lipomas of long bones were included in the study. The size, involved bone and site, bone destruction pattern, border, internal calcification, bony expansion, cortical disruption and endosteal erosion were retrospectively analyzed on plain radiograph. The cases were classified into three stages based on calcification and cystic change. Eccentricity, margin, signal intensity of internal fatty portion, and presence of enhancement were analyzed.
Results: Twelve tumors were located in femur and 8 in humerus. Proximal metaphysis was the most common involved site, with 14 cases. All tumors had geographic bone destruction, with sclerotic rim in 18 cases on plain radiograph. Internal calcification was seen in 18 cases and bony expansion in 6 cases. Twenty-three cases had cystic change in MRI. Eleven cases had eccentric location. The margins were well-defined in 11 cases. High signal intensity of fatty portion on fat-sat T2-weighted image was present in 17 cases. Contrast enhancement was seen in 17 cases.
Conclusion: Knowledge of plain radiographic and MRI findings of intraosseous lipoma of long bones is valuable to the tumor diagnosis differentiation from other bone lesions.

국문 초록 (Abstract)

목적: 장관골에 발생한 골내지방종의 단순촬영 소견과 자기공명영상(magnetic resonance image; 이하 MRI) 소견을 알아보고자 하였다.
대상과 방법: 장관골의 골내지방종으로 진단된 환자 중 단순촬영과 MRI를 시행한 27예를 대상으로 하였다. 단순촬영에서 크기, 위치, 골파괴 양상, 경계, 내부 석회화, 뼈확장, 피질골 단절 및 골내막 미란 등을 분석하였다. MRI에서는 석회화와 낭성변화에 따라 세 병기(stage)로 분류하였고, 병변의 경계, 편심성, 지방성분의 신호강도와 조영증강 유무를 평가하였다.
결과: 총 27예 중 대퇴골에서 12예, 상박골에서 8예가 발견되었고, 상부 골간단에서 발생한 경우가 14예로 가장 많았다. 단순촬영에서 모두 지도형 골파괴 양상을 보였으며, 경화성 테두리가 있는 경우가 18예로 가장 많았다. 내부 석회화는 18예에서, 뼈확장은 6예에서 관찰되었다. MRI에서 낭성변화가 있는 경우가 23예였고, 골수강 내에 편심성으로 위치하는 경우가 11예였다. 경계는 분명한 경우가 11예, 불분명한 경우가 16예였다. 병변의 지방성분이 높은 신호강도를 보인 경우가 17예였다. 조영제 주입 후 조영증강이 되는 경우는 17예였다.
결론: 장관골에 발생한 골내지방종의 단순촬영과 MRI 소견을 이해하는 것은 장관골에 발생한 골내지방종의 진단과 다른 골병변과의 감별에 도움이 된다.

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