纤维性骨皮质缺损的影像表现与临床研究价值(1)
【摘要】 目的 探讨纤维性骨皮质缺损的影像表现与临床研究价值。方法 回顾性分析26例(29个病灶)均有平片资料,其中12例(13个病灶)有CT资料, 3例(4个病灶)有MRI资料,9例(10个病灶)经随访观察1~4年, 2例手术病理证实。结果26例共29个病灶,其中股骨远侧干骺部14个,胫骨近侧干骺部7个,胫骨骨干4个,股骨近侧干骺部3个,肱骨近侧干骺部2个;单发19例,多发7例。X线表现:多呈类圆形或椭圆形的低密度灶,切线位呈杯口状或碟状的骨皮质缺损区,病灶内缘可见硬化边,周围未见骨膜反应及软组织肿胀。13个病灶CT表现:缺损可位于骨皮质表层(9个)或骨皮质内(4个),位于骨皮质表层者缺损表面无骨壳,局限于骨皮质内者缺损表面骨壳可完整; 7个病灶凹向髓腔并以硬化边与髓腔分隔,但无膨胀性改变或突入髓腔;灶内为均匀软组织密度,未见钙化灶。9个病灶经随访观察,其中3个病灶无改变,3个病灶稍有缩小, 2个病灶发展为非骨化性纤维瘤。结论典型的纤维性骨皮质缺损单凭平片即
可诊断,但CT、MRI比平片更有价值。
, http://www.100md.com
【关键词】纤维性骨皮质缺损; 骨骼; X线计算机, 放射摄影术
中图分类号:R814文献标识码:A文章编号:1005-0515(2010)02-001-03
Imaging Appearance and clinical research value of Fibrous Cortical Defect
Fu ming-hua
(Department of Radiology,Liangang Hospital,Loudi,417009, China)
【Abstract】ObjectiveTo evaluate Imaging Appearance and clinical research value of fibrous cortical defect (FCD). Methods26 cases (29 lesions )with fibrous cortical defect were examined with radiography, and CT scan was performed in 12 cases (13 lesions),and MRI scan was performed in 3 cases (4 lesions),9 cases (10 lesions) were followed up for 1 ~ 4 years. 2 cases were proved by operation and pathology.ResultsTotal 29 lesions were found in 26 cases, of which the lesion was located at distal metaphysis of femur in 14, at proximal metaphysis of tibia in 7, at diaphysis of tibia in 4, at proximal metaphysis of femur in 3 and at proximal metaphysis of humerus in 2. Single lesion was seen in 19 patients, while multiple lesions in 7. On radiography, the lesions mostly appeared as round or oval low dense area; on tangential projection, the lesions presented as the mouth of cup or crater form; all lesions had a clear sclerosing margin at the marrow side and without periosteal reaction as well as soft tissue swelling around. On CT scan, 11 lesions were located with in cortical bone and the bone shell was not detected on the surface of defect, while 3 lesions were located at surface of cortical bone with the bone shell on the surface of defect. 7 lesions were indentation to bone marrow cavity slightly and separated with a sclerotic margin, the lesions did not protrude in to marrow cavity or expand. The soft tissue within the lesion was even in soft tissue density without calcifications. During following - up period,2 lesion enlarged and developed into nonossifying fibroma, while regression of the lesion in some extent was seen in 3, and 3 lesions remained the same. ConclusionTypical FCD can be diagnosed by X-ray plain film alone, while CT/MRI scan is superior to X-ray in displaying the lesion.
, 百拇医药
【Key words】 fibrous cortical defect; bone;x-ray computed, radiography
1 材料与方法
1.1 临床资料
本组26例,其中男16例,女10例,年龄6~25岁,平均14.5岁,其中双侧对称发病3例。16例无明显临床症状,因外伤或其他原因来诊,6例有轻度间歇性顿痛,劳累后明显加重,但无局部肿胀。4例病灶较大伴有临床症状行手术搔刮治疗。9例(10个病灶)经随访观察,其中5个病灶追踪3年以上。
1.2 检查方法
X线平片检查使用X线机为FB、GT22型及GE.prestige-11型,常规摄正侧位片,部分加摄斜位、切线位。CT机为Siemens Somatom Sensation 6排螺旋CT机,扫描参数120KV/150MA/0.5S扫描层厚和层距一般为2mm,病灶较小者采用1mm薄层扫描,均摄骨窗和软组织窗观察。
2 结果
2.1 病变部位及分布 26例共29个病灶均位于长管状骨,包括股骨14个,胫骨7个,肱骨2个,干骺部19个,骨干7个,其中以股骨远侧干骺部14个,为最多见,其次为胫骨近侧干骺部5个,胫骨骨干2个,股骨近侧干骺部3个,肱骨近侧干骺部2个。单发19例,多发7例,后者均为股骨远侧干骺部双侧对称性发病。病灶长径0.7~3. 3 cm,平均1. 7 cm,横径0. 3~2. 1cm,平均1. 15 cm。, http://www.100md.com(扶明华)
可诊断,但CT、MRI比平片更有价值。
, http://www.100md.com
【关键词】纤维性骨皮质缺损; 骨骼; X线计算机, 放射摄影术
中图分类号:R814文献标识码:A文章编号:1005-0515(2010)02-001-03
Imaging Appearance and clinical research value of Fibrous Cortical Defect
Fu ming-hua
(Department of Radiology,Liangang Hospital,Loudi,417009, China)
【Abstract】ObjectiveTo evaluate Imaging Appearance and clinical research value of fibrous cortical defect (FCD). Methods26 cases (29 lesions )with fibrous cortical defect were examined with radiography, and CT scan was performed in 12 cases (13 lesions),and MRI scan was performed in 3 cases (4 lesions),9 cases (10 lesions) were followed up for 1 ~ 4 years. 2 cases were proved by operation and pathology.ResultsTotal 29 lesions were found in 26 cases, of which the lesion was located at distal metaphysis of femur in 14, at proximal metaphysis of tibia in 7, at diaphysis of tibia in 4, at proximal metaphysis of femur in 3 and at proximal metaphysis of humerus in 2. Single lesion was seen in 19 patients, while multiple lesions in 7. On radiography, the lesions mostly appeared as round or oval low dense area; on tangential projection, the lesions presented as the mouth of cup or crater form; all lesions had a clear sclerosing margin at the marrow side and without periosteal reaction as well as soft tissue swelling around. On CT scan, 11 lesions were located with in cortical bone and the bone shell was not detected on the surface of defect, while 3 lesions were located at surface of cortical bone with the bone shell on the surface of defect. 7 lesions were indentation to bone marrow cavity slightly and separated with a sclerotic margin, the lesions did not protrude in to marrow cavity or expand. The soft tissue within the lesion was even in soft tissue density without calcifications. During following - up period,2 lesion enlarged and developed into nonossifying fibroma, while regression of the lesion in some extent was seen in 3, and 3 lesions remained the same. ConclusionTypical FCD can be diagnosed by X-ray plain film alone, while CT/MRI scan is superior to X-ray in displaying the lesion.
, 百拇医药
【Key words】 fibrous cortical defect; bone;x-ray computed, radiography
1 材料与方法
1.1 临床资料
本组26例,其中男16例,女10例,年龄6~25岁,平均14.5岁,其中双侧对称发病3例。16例无明显临床症状,因外伤或其他原因来诊,6例有轻度间歇性顿痛,劳累后明显加重,但无局部肿胀。4例病灶较大伴有临床症状行手术搔刮治疗。9例(10个病灶)经随访观察,其中5个病灶追踪3年以上。
1.2 检查方法
X线平片检查使用X线机为FB、GT22型及GE.prestige-11型,常规摄正侧位片,部分加摄斜位、切线位。CT机为Siemens Somatom Sensation 6排螺旋CT机,扫描参数120KV/150MA/0.5S扫描层厚和层距一般为2mm,病灶较小者采用1mm薄层扫描,均摄骨窗和软组织窗观察。
2 结果
2.1 病变部位及分布 26例共29个病灶均位于长管状骨,包括股骨14个,胫骨7个,肱骨2个,干骺部19个,骨干7个,其中以股骨远侧干骺部14个,为最多见,其次为胫骨近侧干骺部5个,胫骨骨干2个,股骨近侧干骺部3个,肱骨近侧干骺部2个。单发19例,多发7例,后者均为股骨远侧干骺部双侧对称性发病。病灶长径0.7~3. 3 cm,平均1. 7 cm,横径0. 3~2. 1cm,平均1. 15 cm。, http://www.100md.com(扶明华)