非骨化性纤维瘤的影像诊断
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摘要
目的探讨非骨化性纤维瘤的影像学表现,提高对非骨化性纤维瘤诊断的准确性与鉴别诊断水平。方法回顾性分析27例经手术病理证实的非骨化性纤维瘤患者的临床及影像学资料。其中15例行X线检查,17例行CT检查,19例行MRI检查(5例增强扫描),分析病例性别及年龄、病灶的发生部位、形态学特征、密度及信号特征。结果男性19例,女性8例,年龄4~57岁,平均年龄15.6岁。位于股骨下端12例,胫骨上端4例,胫骨下端3例,腓骨上端3例,肱骨上端3例,2例发生在不规则骨。长骨病灶均位于干骺端,偏于一侧生长,位于皮质或皮质下,病灶长轴与骨干平行。病灶形态呈单房型7例,多房型19例,不规则型1例。25例病灶累及髓腔。24例行X线或CT检查者的病灶均表现为低密度,有薄层硬化边,可伴有轻微膨胀,骨皮质变薄。19例行MRI检查病例中,病灶呈长T1短T2者15例,长T1长T2者3例,短T1长T2者1例,13例压脂T2WI为均匀高或混杂高信号,6例为低信号,5例增强病灶均呈明显强化。结论 X线、CT、MRI在诊断非骨化性纤维瘤方面有特征性的影像学表现,特定的发生年龄、发病部位、影像学表现对非骨化性纤维瘤的诊断具有重要意义。
Objective To investigate the imaging diagnosis of non-ossifying fibroma,so that we can improve the diagnostic accuracyand and differential diagnosis of non-ossifying fibroma. Methods The clinical and imaging data of 27 cases with non-ossifying fibroma proved by operation and pathology were retrospectively analyzed. Among them,15 cases were examined with X-ray,17 cases with CT,and 19 cases with MRI( 5 with enhanced scan). The sex and age of the patients,the location of the lesion,the morphological characteristics,the density and the signal characteristics were analyzed. Results There were 19 males and 8 females. The age range was 4 ~ 57 years old,with an average age of 15. 6 years. There were 12 cases whose lesions were found in distal femur,4 cases in proximal tibial,3 cases in tibial distal,3 cases in proximal fibula,3 cases in proximal humerus and 2 cases in irregular bone. Lesions of the long bone were located in metaphyses,which leans to one side,and were located in cortex or subcortex,the long axis of lesions parallel to the backbone. Single type of lesions morphology in 7 cases,multiple types in 19 cases,irregular type in 1 case. 25 cases of lesions involved the medullary cavity. 24 cases with X-ray or CT inspectors lesions were characterized by low density,they were shown thin sclerotic margin,and may be accompanied by slight expansion and thinning of the bone cortex. Among 19 cases of routine MRI lesions,there were 15 cases with short T1 and long T2,3 cases of long T1 and long T2,1 case of short T1 and long T2,13 cases of fat suppression T2 WI with uniform or mixed high signal,6 cases of low signal and 5 enhanced lesions were significantly improved. Conclusion X-ray,CT and MRI have characteristic imaging findings in the diagnosis of non-ossifying fibroma. The specific occurrence of age,pathogenic site and imaging findings are of great significance for the diagnosis of non-ossifying fibroma.
Objective To investigate the imaging diagnosis of non-ossifying fibroma,so that we can improve the diagnostic accuracyand and differential diagnosis of non-ossifying fibroma. Methods The clinical and imaging data of 27 cases with non-ossifying fibroma proved by operation and pathology were retrospectively analyzed. Among them,15 cases were examined with X-ray,17 cases with CT,and 19 cases with MRI( 5 with enhanced scan). The sex and age of the patients,the location of the lesion,the morphological characteristics,the density and the signal characteristics were analyzed. Results There were 19 males and 8 females. The age range was 4 ~ 57 years old,with an average age of 15. 6 years. There were 12 cases whose lesions were found in distal femur,4 cases in proximal tibial,3 cases in tibial distal,3 cases in proximal fibula,3 cases in proximal humerus and 2 cases in irregular bone. Lesions of the long bone were located in metaphyses,which leans to one side,and were located in cortex or subcortex,the long axis of lesions parallel to the backbone. Single type of lesions morphology in 7 cases,multiple types in 19 cases,irregular type in 1 case. 25 cases of lesions involved the medullary cavity. 24 cases with X-ray or CT inspectors lesions were characterized by low density,they were shown thin sclerotic margin,and may be accompanied by slight expansion and thinning of the bone cortex. Among 19 cases of routine MRI lesions,there were 15 cases with short T1 and long T2,3 cases of long T1 and long T2,1 case of short T1 and long T2,13 cases of fat suppression T2 WI with uniform or mixed high signal,6 cases of low signal and 5 enhanced lesions were significantly improved. Conclusion X-ray,CT and MRI have characteristic imaging findings in the diagnosis of non-ossifying fibroma. The specific occurrence of age,pathogenic site and imaging findings are of great significance for the diagnosis of non-ossifying fibroma.
引文
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[2]梁碧玲.骨与关节疾病影像诊断学[M].北京:人民卫生出版社,2006.407.
[3]ADAM GREENSPAN著,唐光健,译.骨放射学[M].第3版.北京:中国医药出版社,2003.599-601.
[4]张保付,郭秀敏,韩桂芬,等.非骨化性纤维瘤21例X线与CT分析[J].医学影像学杂志,2013,23(9):1472-1473.
[5]林海勇,丁有泉.非骨化性纤维瘤的影像学评价[J].医学影像学杂志,2010,20(5):759-760.
[6]乔继红,代向党,王赢,等.长骨非骨化纤维瘤的X线及CT表现与病理基础(附17例报告)[J].实用放射学杂志2006,22(8):976-977,1017.
[7]江浩.骨与关节MRI[M].第2版,上海:上海技术出版社,2011.376-377.
[8]丁建林,易旦冰,梁立华.非骨化性纤维瘤的影像学诊断[J].影像诊断与介入放射学杂志,2006,15(2):72-75.