来源：jxradiology
上次我们医影发了一篇椎管内积气的文章，超过1万人学习，点击查看——漏诊误诊27期—椎管内积气，一个易被忽视的影像！
如果在颈腰椎CT片，看到椎骨里的气体密度影，你会考虑什么？相信很多同行朋友会有此类困惑。今天医影带大家一起学习下该病。
影像资料
Vertebral pneumatocysts refer to the presence of air filled cavity within the vertebrae, more prevalent on the cervical spine. Intraosseous pneumatocysts are more common adjacent to the sacroiliac joint while it is rare in the vertebral column. Other causes of vertebral air e.g. Kummel disease, osteomyelitis, post surgery and necrotic tumor should be excluded.
椎体含气囊肿是指椎体内存在含气的空腔，常见于颈椎。骨内含气囊肿在骶髂关节附近更常见，而在脊柱中罕见。应排除其它导致椎体积气的病因：Kummel病，骨髓炎，手术后和坏死性肿瘤。
Pathogenesis
Although not completely understood, some authors believe it is an extension from the intradiscal air (vacuum phenomenon) . On follow up of these lesions they changed to fluid filled cavities and became granulation tissue later on . Some of these lesions enlarged in size .
尽管病因尚不明，一些作者认为它是椎间盘内空气的扩展（真空现象）。随访发现这些病灶开始变为充满液体的囊腔，随后变成肉芽组织。有些病灶会增大。
Radiographic features
Plain radiograph
Difficult to detect but sometimes air lucencies are seen within the vertebral bodies.
CT
Considered the best method of diagnosis. Air measures about -800 to -1000 HU in density. Detection of associated intradiscal air and communication between the vertebral and intradiscal gas can be demonstrated. Also epidural extension can be easily detected.
MRI
Air appears as low signal on both T1 and T2 which confuses with sclerotic lesions so CT is pathognomonic.
Treatment and prognosis
Follow up to detect any increase in the size but no specific treatment.
随访发现一些病灶会增大，但不需要特别治疗。
Differential diagnosis
Sclerotic lesions e.g. metastasis, Kummel disease, vertebral osteomyelitis, post surgery and tumour with necrosis.
总结：椎体内含气非常罕见，国内外报道均鲜有报道。
两种类型：1、患者年龄较轻，表现为小圆形病灶，无椎体退变；
2、年龄较大，病灶也较大，有椎体退变。
Hall等随访4年的髂骨含气囊肿逐渐增大；有学者随访6个月-2年未发生变化；也有报道发现1-16个月后，自发转变为液性囊肿，后变为软组织密度（可能为含气囊肿与周围骨髓存在压力差时，导致气体扩散及液体积聚，之后囊样结构可被肉芽组织取代）。
总之，颈椎骨内含气囊肿为良性病灶，不需要特别治疗。
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