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"猫头鹰眨眼征”，这个征象提示啥?

2022-07-15 熊猫放射 熊猫放射

猫头鹰眨眼征
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几个病例让你秒懂“猫头鹰眨眼征”。

几个病例让你秒懂“猫头鹰眨眼征”。
先看一个病例：患者，女性，70岁，乳房肿块，背部疼痛。腰椎正侧位平片如下图所示：
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左侧L1椎弓根消失。可将其与同一水平的清晰右侧椎弓根和上下水平椎弓根进行对称性比较。
腰椎CT骨窗图像如下所示：
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诊断：乳腺癌多发骨转移，其中包括了平片中所示的L1左侧椎弓根转移。
同时可见：肝脏多发转移。
猫头鹰眨眼征
（缺少）椎弓根征，也称为猫头鹰眨眼征。平片上，当椎弓根不存在时就会出现“猫头鹰眨眼”，其中缺失的椎弓根对应闭合的眼睛，对侧椎弓根对应于另一只睁眼。此外，在胸椎或腰椎的正位片上棘突对应动物的喙。
1、发生原因
（1）椎弓根骨质破坏：脊柱转移瘤、脊柱恶性肿瘤、结核病和其他感染；不常见：原发性骨病变；淋巴瘤。
（2）先天性椎弓根缺如/发育不全。
（3）神经纤维瘤病。
（4）显示不够清晰（其它原因）。
（5）放射治疗。
2、举例说明
（1）T11椎体转移瘤（胸椎正位片可见T11左侧椎弓根缺如）。
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（2）隐匿性脊柱闭合不全：先天性左侧椎弓根缺如，L3左后弓缺失；L2-3椎体棘突明显融合。
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（3）脊柱结核。男30岁，胸痛。胸部平片示L1右侧椎弓根缺如（猫头鹰眼征），CT示T10椎体、L1椎体及左侧椎弓根、右侧第7肋多发骨质破坏。穿刺活检查见结核分枝杆菌。
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    2022-10-12 仁者大医

    #眨眼#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1745781, encodeId=5ebd1e45781f1, content=<a href='/topic/show?id=e46ce2690c5' target=_blank style='color:#2F92EE;'>#眨眼#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72690, encryptionId=e46ce2690c5, topicName=眨眼)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Oct 12 02:51:00 CST 2022, time=2022-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1233190, encodeId=a32d123319044, content=附件转移瘤, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8a585215784, createdName=1476c801m37(暂无昵称), createdTime=Mon Jul 18 13:55:24 CST 2022, time=2022-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232773, encodeId=f4d21232e7373, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa465185483, createdName=周寻, createdTime=Sat Jul 16 11:20:47 CST 2022, time=2022-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232729, encodeId=8f541232e2937, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6b9f5103330, createdName=145fbe3dm27暂无昵称, createdTime=Sat Jul 16 01:30:14 CST 2022, time=2022-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232694, encodeId=49c11232694ad, content=学习了，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7e82338464, createdName=12286003m71暂无昵称, createdTime=Fri Jul 15 22:27:54 CST 2022, time=2022-07-15, status=1, ipAttribution=)]
    2022-07-18 1476c801m37(暂无昵称)

    附件转移瘤

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1745781, encodeId=5ebd1e45781f1, content=<a href='/topic/show?id=e46ce2690c5' target=_blank style='color:#2F92EE;'>#眨眼#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72690, encryptionId=e46ce2690c5, topicName=眨眼)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Oct 12 02:51:00 CST 2022, time=2022-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1233190, encodeId=a32d123319044, content=附件转移瘤, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8a585215784, createdName=1476c801m37(暂无昵称), createdTime=Mon Jul 18 13:55:24 CST 2022, time=2022-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232773, encodeId=f4d21232e7373, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa465185483, createdName=周寻, createdTime=Sat Jul 16 11:20:47 CST 2022, time=2022-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232729, encodeId=8f541232e2937, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6b9f5103330, createdName=145fbe3dm27暂无昵称, createdTime=Sat Jul 16 01:30:14 CST 2022, time=2022-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232694, encodeId=49c11232694ad, content=学习了，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7e82338464, createdName=12286003m71暂无昵称, createdTime=Fri Jul 15 22:27:54 CST 2022, time=2022-07-15, status=1, ipAttribution=)]
    2022-07-16 周寻

    学习了

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1745781, encodeId=5ebd1e45781f1, content=<a href='/topic/show?id=e46ce2690c5' target=_blank style='color:#2F92EE;'>#眨眼#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72690, encryptionId=e46ce2690c5, topicName=眨眼)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Oct 12 02:51:00 CST 2022, time=2022-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1233190, encodeId=a32d123319044, content=附件转移瘤, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8a585215784, createdName=1476c801m37(暂无昵称), createdTime=Mon Jul 18 13:55:24 CST 2022, time=2022-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232773, encodeId=f4d21232e7373, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa465185483, createdName=周寻, createdTime=Sat Jul 16 11:20:47 CST 2022, time=2022-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232729, encodeId=8f541232e2937, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6b9f5103330, createdName=145fbe3dm27暂无昵称, createdTime=Sat Jul 16 01:30:14 CST 2022, time=2022-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232694, encodeId=49c11232694ad, content=学习了，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7e82338464, createdName=12286003m71暂无昵称, createdTime=Fri Jul 15 22:27:54 CST 2022, time=2022-07-15, status=1, ipAttribution=)]
    2022-07-16 145fbe3dm27暂无昵称

    学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1745781, encodeId=5ebd1e45781f1, content=<a href='/topic/show?id=e46ce2690c5' target=_blank style='color:#2F92EE;'>#眨眼#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72690, encryptionId=e46ce2690c5, topicName=眨眼)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8e886, createdName=仁者大医, createdTime=Wed Oct 12 02:51:00 CST 2022, time=2022-10-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1233190, encodeId=a32d123319044, content=附件转移瘤, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8a585215784, createdName=1476c801m37(暂无昵称), createdTime=Mon Jul 18 13:55:24 CST 2022, time=2022-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232773, encodeId=f4d21232e7373, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=aa465185483, createdName=周寻, createdTime=Sat Jul 16 11:20:47 CST 2022, time=2022-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232729, encodeId=8f541232e2937, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6b9f5103330, createdName=145fbe3dm27暂无昵称, createdTime=Sat Jul 16 01:30:14 CST 2022, time=2022-07-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1232694, encodeId=49c11232694ad, content=学习了，谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e7e82338464, createdName=12286003m71暂无昵称, createdTime=Fri Jul 15 22:27:54 CST 2022, time=2022-07-15, status=1, ipAttribution=)]
    2022-07-15 12286003m71暂无昵称

    学习了，谢谢

    0