足菌肿的临床X线表现(附18例报告)

目的：探讨足菌肿的临床X线表现特点，以提高对本病的认识，方法：回顾性分析18例足菌肿的临床X线表现，并结合文献进行讨论。结果：18例67块骨受累，其中跖骨30块，楔状骨20块，骰骨7块，趾骨5块，胫骨3块，跟骨2块。骨质呈侵蚀性破坏8例，溶骨样破坏3例，囊状破坏3例，侵蚀性破坏伴增生硬化2例，增生硬化改变2例。骨皮质呈不规则增厚9例，骨皮质残缺不齐7例，呈层状及花边状骨膜反应12例，有长短不一的骨嵴3例，邻近骨质疏松13例，关节面模糊11例，关节间隙狭窄8例，软组织内有斑点状钙化2例，有2－3cm长的死骨片2例；分叶而界限不清的软组织团块影2例。18例在颗粒中均发现菌丝，颗粒颜色呈褐色或黑色。结论：足菌肿病变范围广，易累及多骨，骨质以侵蚀性及溶骨性破坏为主要X线征象。

Clincal and X-ray findings of mycetoma (report of 18 cases)

Objective To investigate the characteristic clincal and X-ray findings of mycetoma and to enhance the undestanding of mycetoma. Methods The clinical and X-ray findings of mycetoma in 18 cases were analyzed with the review of literatures. There were 11 males and 7 females, the age ranged from 21-65 years, with the average of 41.5 year. The cases were all peasants, barefoot and with the history of trauma, which lasted for 4-17 years with the aveage of 9.8 year. Results Sixty-seven lesions of bone in 18 cases (30 metatarsal, 20 cuneiform, 7 cuboid, 5 phalanx, 3 tibia, 2 calcaneu) were presented, including 8 rodent, 3 osteolytic, 3 cystic, 2 rodent and sclerosis changes, 2 sclerosis, 9 irregular thickened bony cortex, 7 irregular deleted bony cortex, 12 periosteal reaction, 3 irregular crest of bone in lesion, 13 rarefaction of bone cortex, 11 swimmy of surface arthroses, 8 constriction of interval arthroses, 2 spot calcification in the soft tissue, 2 sequestrum, and 2 soft tissue mass. The mycelium had been discovered in grain in 18 cases and the colour of grain was from brown to black. Conclusion Mycetoma involves extensively and tends to involve multiple bones. The main X-ray findings are rodent and osteolytic changes.