摘要
目的探讨纤维性骨皮质缺损的各种影像表现,重点是确定X线和CT表现以及MRI表现在诊断中的意义。方法搜集了经临床追踪或手术病理证实25例患者,25例全部摄平片,其中12例行CT检查,5例行MRI扫描,并分析纤维性骨皮质缺损的X线、CT、MRI特点。结果25例共30个病灶,其中16个位于股骨下干骺端,5个位于股骨近端,4个位于胫骨近端,3个位于腓骨干骺端,1个位于尺骨下端,1个位于锁骨。单骨单发21例;多发4例中,,单骨双发一例,双骨单发2例,3骨单发病灶1例。X线表现;缺损的大小为0.6～3.6cm,病灶位于干骺端皮质内或自骨皮质膨向髓腔,呈卵圆形、分叶状或“泪滴”状偏心性骨皮质缺损区,病变长轴与骨干平行,病灶表面可无骨壳,周有骨性硬化边,局部皮质可膨大变薄或毛糙,无骨膜反应及软组织肿块,部分缺损内有纵行骨性分隔。CT表现12个病灶为皮质内囊状或不规则无膨胀骨质破坏区,外侧骨壳完整或缺损,邻近骨质无骨膜反应,28个病灶邻近软组织无肿胀,仅两个有轻微肿胀。MRI:5例MRI表现T1WI、T2WI均为低信号,周边硬化缘更低。30个病灶随访观察,无1例病灶扩大或出现新病灶,18个病灶随访复查逐渐被增生骨质填充缩小,8个病灶无变化,4个病灶经复查,病灶完全消失。结论X线、CT和MRI对纤维性骨皮质缺损能进行准确诊断。
Objective To investigate the findings of fibro us cortical defects of bones(FCD)on various imagins modalities and to deter-mine emphatically the importance of X -ray and computed tomography(CT)as well as magnetic resonance imagin g(MRI )findings in establish-ing the diagnosis.Methods Twenty five patients with clinically or pathologically proved FCD underwent X -ray plain film examinations.12patients underwent additional CT sc ans and 5patients underwent additio nal MRI examinations.The findings o f FCD on above three imaging modalities were analyzed retrospec tively in all cases.Results among 30lesions of FCD seen in 25patients,16lesions(53.3%)located in distal femoral metaphysis,5(16.6%)in proximal femoral metaphysis,4(13.3%)in proximal tibial metaphysis,3(13%)in fibular metaph-ysis,1(3.3%)in ulnar inferior end and 1(3.3%)in clavicle.Single lesions of uniostotic FCD were found in 21of 25cases(84%),multi-ple lesions of uniostotic or polyostotic FCD were found in 4of 25cases(16%).On X -ray plain films,the size of FCD lesions ranged be-tween 0.6cm and 3.6cm ,the most lacated within cortex of metaphysis or exp anded from cortem to medullary cavities,some presented as oval,lobulated or“teardrop”and eccentric cortical defect regio ns.The long axis of the lesions was paraller to the longitudinal axis of th e bone,the surface was not covered by b one shell,the periphery had an osteosclerotic edge.Local cortex of bone was expanded and thinned or became into microvillus -form wit hout sub periotenum reaction and soft tissae masses.The portional corti cal defect regions had longitudi-nal boned septum.On CT imaes,12of 30lesions presented as intracortical cystic form or irrgeularities without expansive destruction regions of the bones,the external bone shell s were complete or defective,adjacent bones had not sub -periotenum reac tion,while other 18lesions no swelling observed in adjacent soft t issue but only slight swelling was ob served in 2lesions.MRI revealed that FCD lesions in 5patients who underwent MRI examinations showed h ypointense on T 1 WI and T 2 WI whereas the peripheral sclerotic edge showed more lower intensity.The follow up demonstrated that.among 30lesions,neither the expansion of primary lesions nor the recurrence of new lesions were observed,of them,16lesions became narrowing due to sub -periosteal new bone formation,10lesions non changed,and 4lesions completely van-ished.Conclusion X -ray,CT and MRI can accurately diagnose FCD and can predict its transformation process through follow -up ob serva-tion.[
出处
《实用医学影像杂志》
2003年第3期148-150,共3页
Journal of Practical Medical Imaging
