Imaging of a Stafne bone cavity: what MR adds and why a new name is needed.

Stafne bone cavities are asymptomatic radiolucencies seen at the angle of the mandible. Although plain films are often sufficient for diagnosis, confirmatory imaging is needed in atypical cases. We describe the MR imaging findings of a Stafne bone cavity, describe the contents, explain why a new name is needed, and discuss the relative merits of different radiologic techniques for establishing this diagnosis.     

CT analysis of the Stafne's bone defects of the mandible

OBJECTIVE: To investigate the aetiology of Stafne's bone defects by analysing the CT findings of two types of defects, which appeared differently on panoramic radiographs. METHODS: 32 lesions with suspicion of the Stafne's bone defect on a panoramic radiograph were categorised into two groups: typical "Stafne type", which showed the connection to the base of the mandible, and non-typical "Cyst type", which showed no connection. Age, sex, the existence of hypertension and the following CT findings: location, size and inner content of the defect, existence of expansion of the buccal cortical bone, and location of submandibular glands, were analysed. RESULTS: There were 14 "Stafne type" and 17 "Cyst type" on the panoramic radiographs. One lesion in the "Cyst type" was a true cystic lesion and was excluded from further review. The "Stafne type" was seen primarily in the posterior and inferior locations, while the "Cyst type" was seen in the anterior and superior locations on the CT. The size of the defect was significantly larger in the "Stafne type". Buccal cortical expansion was observed only in three lesions in the "Stafne type". While the "Cyst type" contained mainly fatty tissue, the "Stafne type" contained other soft tissues. Though the submandibular glands on the defect side were located anteriorly in both types compared with those on the contralateral side and on the control patients, they spread mainly outwards in the "Stafne type". CONCLUSION: The Stafne's bone defects are thought to be caused by the dislocated submandibular gland. The differences between the two types might occur as a result of a different location of the submandibular gland.     

Cone beam CT sialography of Stafne bone cavity

Stafne bone cavity (SBC) was mostly described as a small oval radiolucency in the posterior mandibular region. To the best of our knowledge, the literature does not contain any report of the use of cone beam CT (CBCT) sialography for the diagnosis of this entity. The aim of this paper is to present a large, irregular and expanded atypical SBC, which made diagnosis difficult. A CBCT sialography was performed to get a definite diagnosis of this rare entity.     

Anterior Stafne bone defect mimicking a residual cyst: a case report

Stafne bone defects (SBDs) are asymptomatic lingual bone depressions of the lower jaw that are frequently caused by soft tissue inclusion. The common variant of SBDs exists at the third molar region of the mandible below the inferior dental canal and has been mostly diagnosed incidentally during routine radiographic examination. The anterior variant of a SBD (ASBD) is relatively uncommon and is located in the premolar region of the mandible. Sublingual salivary glands are thought to be responsible for ASBDs. However, other structures such as lymphoid or vascular tissues might be associated with ASBDs. In the present report, an ASBD which was mimicking a residual cyst was diagnosed with the aid of a three-dimensional CT scan. ASBDs might be confused with other odontogenic or non-odontogenic pathologies because of their location and lower occurrence rate. Advanced imaging modalities, especially CT scans, are useful to assess such lesions in order to avoid unnecessary surgery.     

An unusual case of multilocular Stafne bone cavity

Stafne bone defects (SBDs) are asymptomatic lingual bone depressions of the lower jaw that are frequently caused by soft-tissue inclusion. The common variant of SBD exists at the third molar region of the mandible below the inferior dental canal is an and ovoid-shaped homogeneous well-defined radiolucency. In this report, an unusual occurrence of SBD with multilocular appearance is presented. Asymptomatic lingual bone defects may represent various radiographic features. Detailed radiographic evaluation with CT scans should be performed to differentiate SBDs from other pathologies.     

Peripheral ossifying fibroma in the oral cavity: CT and MR findings

We report a case of peripheral ossifying fibroma arising from the anterior oral cavity in a 12-year-old boy. CT and MR scans showed a large exophytic soft tissue mass overlying the anterior hard palate and maxillary alveolar ridge. The tumour revealed peripheral calcification without adjacent bone changes.     

多层螺旋CT评价复发性肩关节前方脱位的前方关节盂骨质缺损的临床意义

目的 在复发性肩关节前方脱位中,利用MSCT评估关节盂前方骨质缺损情况.方法 回顾分析108例复发性肩关节前脱位和12例单次肩关节脱位患者的MSCT检查,对比评价前方关节盂骨质缺损的发生率、程度及位置.利用Fisher精确概率法分析前方关节盂骨质缺损的发生率,利用Wilcoxon秩和检验比较前方关节盂骨质缺损的上下长径、深度及比例.结果 在复发性肩关节前脱位中,91.7％(99/108)存在前方关节盂的骨质缺损,缺损比例为(16.0±6.0)％,缺损中心位置介于时钟分区的2:20～ 4:25点(平均3:20点),62.0％(67/108)前方出现骨性Bankart病变,包括游离型39例(58.2％)及黏附型28例(41.8％).12例单次肩关节脱位中,9例出现前方关节盂骨质缺损,其缺损发生率(9/12;P=0.100)和缺损比例[(15.2±7.1)％;P=0.453]与复发性肩关节脱位比较差异均无统计学意义.结论 前方关节盂骨质缺损为复发性肩关节前方脱位的常见表现.     

原发性鼻腔鼻窦恶性淋巴瘤的CT表现

目的:探讨鼻腔鼻窦恶性淋巴瘤的CT特点。材料和方法:回顾分析14例经病理证实鼻腔鼻窦淋巴瘤的CT表现。结果:鼻腔病灶12例,9例起源于鼻腔前部或鼻前庭,鼻窦腔病灶2例;病灶肿块表现4例,浸润表现3例,混合表现7例,多数(11/14)密度相对均匀;位于鼻窦腔者骨质破坏明显,2例均可见骨质缺损;位于鼻腔者骨质破坏不明显或较轻微,5例可见骨质吸收;病灶易累及邻近结构,6例鼻翼、鼻背部皮肤肿胀,皮下脂肪层消失,3例颊部软组织肿胀。结论:鼻腔鼻窦恶性淋巴瘤CT表现有一定特征性。     

髋臼骨折CT与X线平片检查比较

目的探讨CT与X线平片检查在髋臼骨折诊断中的临床应用价值。方法对照分析18例髋臼骨折CT、X线平片及临床治疗随访资料。结果18例髋臼骨折中前壁骨折4例,前柱骨折4例,后壁骨折2例,后柱骨折2例,复杂骨折6例。伴有盆腔内软组织肿胀11例。其中X线平片误漏诊4例。CT检出骨碎片27块,X线平片检出12块,其中关节腔内游离骨碎片CT检出17块,X线平片检出4块。股骨头脱位7例,伴股骨头骨折3例,其中X线平片漏诊1例。结论CT显示关节腔内碎骨片,确定骨折分型及了解盆腔软组织受损情况优于X线平片检查。     

骨良性纤维病变的影像与病理学分析

目的 提高对骨内良性纤维性病变的影像诊断和鉴别诊断能力. 资料与方法 对96例纤维性骨皮质缺损(FCD)、非骨化性纤维瘤(NOF)、骨化性纤维瘤(OF)和骨纤维异常增殖症(FD)患者的临床、影像学和病理学资料进行比较分析. 结果 FCD和NOF均好发于膝周骨,病理均为无成骨的纤维组织,X线和CT上表现为局限于皮质内和皮质内偏心性膨胀累及髓腔的均匀软组织密度影,MRI上主要为等T1、等T2异常信号.OF和FD病理表现交叉重叠,但OF中成骨细胞镶边现象明显多于FD.OF常见于颅面骨髓腔和胫骨前侧皮质下,表现为单骨内边界清楚的膨胀性不均匀钙质样密度.FD表现为单骨局灶性、弥漫性或多骨囊状膨胀性磨玻璃样改变,MRI上主要为等T1信号,等高混杂T2信号,局灶性FD边缘清楚伴有硬化边,弥漫性FD边界不清. 结论 FCD和NOF因具有相同的好发部位和组织学表现而可将影像学上病变局限于骨皮质者视为FCD,膨胀侵及髓腔者视为NOF.OF和FD的影像学鉴别点在于病变部位、边界和累及范围.     

肋骨嗜酸性肉芽肿的X线及CT表现

目的 分析肋骨嗜酸性肉芽肿的X线及CT表现,提高对该病的诊断水平.方法 回顾性分析8例肋骨嗜酸性肉芽肿的临床资料,所有患者均经穿刺活榆或手术切除后病理证实.全部患者均行X线平片检查;6例行螺旋CT平扫,其中1例行CT增强扫描.结果 8例肋骨嗜酸性肉芽肿均为单发;6例发生于前肋,2例发生于后肋;X线均表现为单房类圆形骨质破坏,境界较清楚.CT扫描表现:5例呈膨胀性骨质破坏,骨皮质变薄,3例呈溶骨件骨质破坏,病灶周围形成软组织肿块;1例行CT增强扫描,病灶呈中度较均匀强化.结论 肋骨嗜酸性肉芽肿的X线平片和CT表现有一定的特征性.     

肋骨嗜酸性肉芽肿的X线及CT表现

目的 分析肋骨嗜酸性肉芽肿的X线及CT表现,提高对该病的诊断水平.方法 回顾性分析8例肋骨嗜酸性肉芽肿的临床资料,所有患者均经穿刺活榆或手术切除后病理证实.全部患者均行X线平片检查;6例行螺旋CT平扫,其中1例行CT增强扫描.结果 8例肋骨嗜酸性肉芽肿均为单发;6例发生于前肋,2例发生于后肋;X线均表现为单房类圆形骨质破坏,境界较清楚.CT扫描表现:5例呈膨胀性骨质破坏,骨皮质变薄,3例呈溶骨件骨质破坏,病灶周围形成软组织肿块;1例行CT增强扫描,病灶呈中度较均匀强化.结论 肋骨嗜酸性肉芽肿的X线平片和CT表现有一定的特征性.     

肋骨嗜酸性肉芽肿的X线及CT表现

目的 分析肋骨嗜酸性肉芽肿的X线及CT表现,提高对该病的诊断水平.方法 回顾性分析8例肋骨嗜酸性肉芽肿的临床资料,所有患者均经穿刺活榆或手术切除后病理证实.全部患者均行X线平片检查;6例行螺旋CT平扫,其中1例行CT增强扫描.结果 8例肋骨嗜酸性肉芽肿均为单发;6例发生于前肋,2例发生于后肋;X线均表现为单房类圆形骨质破坏,境界较清楚.CT扫描表现:5例呈膨胀性骨质破坏,骨皮质变薄,3例呈溶骨件骨质破坏,病灶周围形成软组织肿块;1例行CT增强扫描,病灶呈中度较均匀强化.结论 肋骨嗜酸性肉芽肿的X线平片和CT表现有一定的特征性.     

嗅神经母细胞瘤的CT及MRI影像学表现

目的:探讨鼻腔嗅神经母细胞瘤(ON)的CT及MRI影像学表现特点,以提高对嗅神经母细胞瘤的影像学认识。方法:回顾性分析经手术及组织病理学证实的13例嗅神经母细胞瘤患者的CT及MRI影像学特征及其相关病理学改变。结果:13例患者中,8例行CT平扫,均显示为软组织密度肿块影,其中2例行增强扫描,病灶显著强化;5例行MRI平扫及增强扫描,平扫瘤体信号不均匀,增强后明显不均匀强化。13例中病灶局限于鼻腔者4例;有上颌骨、筛骨、鼻中隔或颅底骨质破坏者9例(69.23%);其中2例侵及同侧的前颅窝(1例有颈部淋巴结转移)。结论:鼻腔中上部肿物,MRI显示内部信号不均匀,而CT显示密度大都较均匀,且增强有明显强化,周围骨质有破坏,甚至病灶自鼻腔延续至前颅窝者,呈"蘑菇"状,应考虑嗅神经母细胞瘤的可能。     

Atypical aesthesioneuroblastoma: CT and MRI findings

Aesthesioneuroblastoma is an uncommon tumour of the superior nasal cavity, originating from the olfactory mucosa. Usually no specific radiological features indicate the diagnosis; normally these tumours are seen on CT as homogeneous, enhacing, soft tissue masses causing bone remodelling. Typical but quite nonspecific MRI findings include high signal on T2-weighted images and strong enhancement after gadolinium. The extent of tumour in the paranasal sinuses and anterior cranial fossa is best assessed with MRI after intravenous gadolinium, and this is considered as the most accurate method for assessing preoperative resectability. We report an aesthesioneuroblastoma in an atypical location, with extensive calcification.     

Plasma-mediated radiofrequency ablation assisted percutaneous cement injection for treating advanced malignant vertebral compression fractures

BACKGROUND AND PURPOSE: Using percutaneous cement injection to treat vertebral compression fractures (VCF) stemming from advanced malignancy, particularly those showing posterior cortical defect and epidural extension, is associated with higher risk of complications compared with treating benign osteoporotic VCF. The purpose of this study was to examine the clinical feasibility of a technique designed to improve control of cement placement. MATERIALS AND METHODS: A prospective series of patients (n = 15) with metastatic lesions having epidural extension of tumor and/or cortical disruption were treated. The percutaneous procedure consisted of using a plasma-mediated radio-frequency-based device to etch a cavity within the affected vertebral body and filling the cavity and adjacent interstices with bone cement. Change in pain status was determined by asking the patient to grade back pain preoperatively and at the 2-4-week postprocedure examination using a visual analog scale. RESULTS: An adequate amount of cement was injected in all cases. Extraosseous extension of cement was observed in 4 cases (anterior cortex, n = 3; through neural foramen, n = 1) but was clinically inconsequential. No thermal or neuronal insult was observed during the procedure in any case. Thirteen of the 15 (87%) patients reported decreased pain. CONCLUSION: Dissolution of tissue rather than displacement to create a cavity before injecting bone cement permitted well-directed cement deposition into the compromised vertebral body, which may allow a safer procedure to be conducted in patients with advanced malignant VCF. Clinical benefits may include avoiding more extensive surgery and reducing the risk of complications associated with conventional bone cement injection procedures.     

Metastatic renal cell carcinoma manifesting as a nasal mass: CT findings

The clinical and radiological findings in a 71-year-old woman with a metastatic renal cell carcinoma to the right nasal cavity are presented. The kidney tumor manifested clinically as epistaxis. Computed tomography revealed an expansile lesion in the right nasal cavity with extension to the right antrum, right ethmoid sinus, and left nasal cavity. There was no lytic bone destruction, but there was displacement of bone caused by the expansile tumor mass.     

Incidence and location of bone bruises after acute posterior cruciate ligament injury

BACKGROUND: In patients suffering from an anterior cruciate ligament injury, the incidence and location of bone bruises are well documented. This study reports data regarding bone bruises after acute posterior cruciate ligament injury. HYPOTHESIS: Bone bruises associated with posterior cruciate ligament injury are common, and their location differs from those seen with anterior cruciate ligament injury. STUDY DESIGN: Retrospective cohort study. METHODS: Thirty-five consecutive patients were identified as having a grade II or III posterior cruciate ligament tear, with an intact anterior cruciate ligament, in which a magnetic resonance imaging scan had been obtained within 20 days of injury. Magnetic resonance imaging scans were reviewed to document bone bruises, associated medial or lateral ligamentous injury, and meniscal and chondral abnormalities. RESULTS: Of the 35 patients, 29 (83%) had a bone bruise in at least one location. Bone bruises were found throughout the joint, more widely dispersed than is commonly seen with anterior cruciate ligament injury. Also, 29 patients had magnetic resonance imaging findings of associated ligamentous injury. Lateral bone bruises were associated with medial collateral ligament injury, whereas medial bone bruises correlated with posterolateral injury. CONCLUSIONS: The incidence of bone bruises associated with posterior cruciate ligament injury is similar to that seen with anterior cruciate ligament injury. Their location is more widely dispersed. The location of a bone bruise should lead to careful magnetic resonance imaging inspection and physical examination for ligamentous injury to the opposite side of the joint. Truly isolated posterior cruciate ligament injuries are rare, as most occur with osseous and some degree of associated ligamentous injury.     

地中海贫血的X线诊断

目的：探讨地中海贫血的X线表现及诊断要点。方法：回顾性分析16例地中海贫血的临床及X线表现。结果：16例患者,全部呈地中海贫血外貌,12例颅骨内外板变薄,板障明显增厚,呈竖发状,4例板障轻度增厚;10例蝶鞍变浅,8例板障型乳突,7例副鼻窦及乳突气化不良;7例肋骨增宽,前端明显膨大;6例椎体骨小梁增粗,呈栅栏状、粗网格状;10例骨盆、四肢骨呈网格状。结论：颅骨内外板变薄,板障明显增厚,呈竖发状,肋骨前端明显膨大,椎体、骨盆、四肢骨呈网格状,是地中海贫血的X线特点,诊断需密切结合临床。