骨纤维异常增殖症的影像诊断分析及应用价值

目的分析骨纤维异常增殖症影像诊断方法及应用价值。方法分析经手术病理证实的28例骨纤维异常增殖症影像资料,所有病例均行X线检查,14例行CT检查,7例行MRI检查,1例行Gd—DTPA增强扫描。结果28例骨纤维异常增殖患者中,单骨型24例,多骨型4例;20例发生囊状改变,5例发生磨玻璃样改变,2例发生丝瓜样改变,1例发生虫蚀样改变。结论骨纤维异常增殖症大多有典型的影像学表现,联合X线、CT、MRI、ECT影像表现可提高诊断准确率。     

骨纤维异常增殖症的影像诊断

目的:探讨骨纤维异常增殖症的影像诊断方法及其价值。方法:搜集经手术病理证实的骨纤维异常增殖症34例,所有病例均行X线检查,其中加行CT 10例,MRI 2例,加行Gd-DTPA增强扫描1例。结果:单骨型27例,其中单骨单灶26例,单骨双灶1例;多骨型7例,其中单肢型2例,1例累及单侧5根肋骨和3节胸椎。X线平片和CT上表现为囊状改变22例,磨玻璃样改变8例,丝瓜络样改变3例,虫蚀样改变1例,合并病理骨折3例。结论:大多数骨纤维异常增殖症具有典型影像学表现,其检查方法仍以X线平片为主,观察复杂部位及病灶内改变以CT为优。低髓腔硬化征对诊断该病具有一定意义。     

骨纤维异常增殖症的影像诊断(附31例报告)

目的　探讨骨纤维异常增殖症的综合影像诊断方法及其价值。方法　报告经手术病理证实的骨纤维异常增殖症 3 1例。3 1例均摄有平片 ,其中加做CT 11例 ,MRI 6例。对比讨论X线平片和CT表现。结果　 3 1例中单骨型 18例 ,多骨型 13例 ,其中骨纤合并骨巨细胞瘤和骨纤合并脑膜瘤各 1例 ,Albright综合征 1例。X线分型 :囊肿型 (18灶 ) ,弥漫型 (3 0灶 ) ,丝瓜络型 (2灶 ) ,虫噬型 (2灶 )。CT表现主要分为囊状膨胀型改变 (3 8灶 )和硬化型改变 (7灶 )。结论　骨纤的影像诊断目前仍以X线平片为主 ,颅面部的病变则CT占优 ,两者结合对大部分骨纤可做出正确的诊断     

股骨颈肿瘤和肿瘤样病变的X线、CT 诊断

目的：探讨原发股骨颈肿瘤和肿瘤样病变的类型、影像表现及鉴别诊断。方法本组共28例,男11例,女17例。骨纤维异常增殖症7例,骨巨细胞瘤5例,韧带样纤维瘤4例,骨囊肿2例,非骨化性纤维瘤2例,内生骨瘤2例,股骨颈疝凹3例,脂肪瘤、恶性淋巴瘤、转移瘤各1例。所有病例均行X线摄片和CT扫描。结果①良性病变和局部侵袭性肿瘤占本组病例的大多数;②各种病例类型中骨纤维异常增殖症最常见（25％）,且发病年龄最轻,平均仅20岁;③骨巨细胞瘤常不局限于股骨颈,易侵犯股骨头和大粗隆,疝凹常见于股骨颈前外上方1/4处;④良性病变及局部侵袭性肿瘤以囊样破坏为主,恶性肿瘤以溶骨性破坏为主;⑤骨纤维异常增殖症的硬化边内缘毛糙,病灶中心常见块状或絮状高密度。骨巨细胞瘤边缘锐利,内缘常可见棘状突起,其内密度均匀。结论综合X线摄片、CT扫描,能提高对股骨颈肿瘤和肿瘤样病变的诊断能力。     

骨纤维异常增殖症

骨纤维异常增殖症又称骨纤维结构不良,简称骨纤,是一种以骨纤维异常增殖变性为特征的骨病.笔者就我院经病理证实的32例骨纤的X线平片及CT检查进行分析,并与病理表现相对照,总结分析如下.     

骨纤维异常增殖症的CT诊断

骨纤维异常增殖症又称骨纤维结构不良,是骨的纤维组织发育紊乱,异常增生所致。总结我院自1991年~2003年CT扫描所见并经手术病理证实骨纤维异常增殖症病例35例,现分析如下。1材料与方法本组35例,男21例,女14例。年龄9~66岁,平均年龄24岁。其中30岁以下者29例,临床症状:局部隆起伴硬性肿物者15例,局部疼痛7例,压痛2例,运动障碍3例,8例查体时偶然发现。2结果CT表现:四肢躯干病变28例,累及骨41个病灶。其中中心型29个病灶,病变位于干骺端或骨干中央。皮质型12个病灶,病变位于骨皮质内。CT表现主要为囊型和硬化型,35个病灶骨呈囊型,表现为囊状…     

骨纤维异常增殖症的CT表现

目的探讨骨纤维异常增殖症的CT表现并与X线所见进行比较。方法8例骨纤维异常增殖症患,其中,6例在颅面骨,2例在四肢骨,临床出现畸形,疼痛及跛行等后接受了CT扫描。CT表现与X线所见作了比较。3例患又经手术病理证实。结果CT显示骨纤维异常增殖症的病灶呈玻璃样改变见于7例,呈膨胀性改变见于8例,呈囊性改变见于4例,呈虫蚀样破坏性改变见于2例,呈硬化性改变见于4例,骨皮质变薄见于6例,增厚见于2例,颧骨受侵见于l例,上颌窦变形、变小见于2例。与X线比较,CT在显示很小和重叠较多的病灶方面明显优于X线。结论CT显示颅面骨中骨纤维异常增殖症病灶的形态与结构改变远比X线影像清晰。     

髋骨良性骨肿瘤及肿瘤样病变的CT分析(附10例分析)

目的探讨髋骨良性骨肿瘤及肿瘤样病变的CT表现.材料和方法经手术病理和临床活检证实共10例,其中成软骨细胞瘤和骨巨细胞瘤各3例,骨纤维异常增殖症2例,非骨化性纤维瘤和嗜酸性肉芽肿各1例.结果CT显示肿瘤钙化机率高于X线平片,但对诊断和鉴别诊断的价值有限;对肿瘤的内部结构和病变周围软组织的显示CT优于X线平片.结论充分利用CT密度分辨力、横断多层面的解剖结构的优越性,可显示X线平片见不到的征象.     

骨纤维异常增殖症X线诊断及鉴别诊断

本文报告经病理证实的64例骨纤维异常增殖症,累及单骨者47例,多骨17例,共计147骨受累。其中有2例作了回顾性病理切片。此症多数表现为磨玻璃状、囊状及斑点状致密影兼有的病灶,患骨向一侧或呈梭形向两侧轻度膨大,骨皮质变薄,但也有一侧或两侧同时增厚者;少数病灶可局限呈囊状透亮腔。文中着重讨论了本病的X 线表现与病理组织学的相关性以及相同部位的其他疾病的X 线鉴别诊断。     

小儿骨纤维异常增殖症X线表现(附24例分析)

骨纤维异常增殖症多为小儿骨科常见病,本组分析24例经临床病理证实的骨纤维异常增殖症的X线资料,以提高X线诊断正确率.     

Maxillofacial fibrous dysplasia: personal experience with gadoliniumenhanced magnetic resonance imaging

PURPOSE: The authors sought to identify radiological criteria assisting in the diagnosis of craniofacial fibrous dysplasia and differential diagnosis of fibro-osseous lesions by comparing computed tomography (CT) and magnetic resonance imaging (MRI) findings and histological results in 23 patients with presumed fibrous dysplasia. MATERIALS AND METHODS: From February 2000 to March 2005, 23 patients (17 women and six men, aged 9-66 years) with facial bone disease underwent CT and MRI studies. Imaging findings were compared with the results of histological examination performed within 1 month of the radiological diagnosis. RESULTS: The combination of CT and MRI led to a presumptive diagnosis of fibrous dysplasia in all cases, but histology confirmed the diagnosis in 18 cases only. In two cases that had initially been considered cyst-like variants of fibrous dysplasia and were associated with irregular enhancement at MRI, histology characterised the lesions as single locations of multiple myeloma. In one case, targeted biopsy of areas showing intense enhancement led to a diagnosis of low-grade fibrosarcoma; in the remaining two cases, the definitive diagnoses were ossifying fibroma and myeloproliferative disease. CONCLUSIONS: MRI proved useful in differentiating fibrous dysplasia from other bone diseases, defining clinical behaviour, identifying neoplastic foci within dysplastic tissue and distinguishing benign from malignant bone lesions. The authors suggest a broader use of contrast-enhanced MRI for the diagnosis and follow-up of dysplastic lesions of the facial bones and for planning appropriate surgical treatment.     

Pseudoanaplastic tumors of bone

Objective To discuss the concept of pseudoanaplastic tumors of bone, which pathologically show hyperchromatism and marked pleomorphism with quite enlarged, pleomorphic nuclei, but with no to extremely rare, typical mitoses, and to propose guidelines for their diagnosis.Design and patients From a database of 4,262 bone tumors covering from 1971 to 2001, 15 cases of pseudoanaplastic bone tumors (0.35% of total) were retrieved for clinical, radiographic and pathologic review. Postoperative follow-up after surgical treatment was at least 3 years and a maximum of 7 years.Results There were eight male and seven female patients. Their ages ranged from 10 to 64 years with average of 29.7 years. Pathologic diagnoses of pseudoanaplastic variants of benign bone tumors included: osteoblastoma (4 cases), giant cell tumor (4 cases), chondromyxoid fibroma (3 cases), fibrous dysplasia (2 cases), fibrous cortical defect (1 case) and aneurysmal bone cyst (1 case). Radiography of all cases showed features of a benign bone lesion. Six cases, one case each of osteoblastoma, fibrous dysplasia, aneurysmal bone cyst, chondromyxoid fibroma, giant cell tumor and osteoblastoma, were initially misdiagnosed as osteosarcoma. The remaining cases were referred for a second opinion to rule out sarcoma.Conclusions Despite the presence of significant cytologic aberrations, none of our cases showed malignant behavior following simple curettage or removal of bony lesions. Our observation justifies the concept of pseudoanaplasia in some benign bone tumors as in benign soft tissue tumors, especially in their late evolutionary stage when bizarre cytologic alterations strongly mimic a sarcoma.     

非骨化性纤维瘤的X线和CT诊断

目的研究非骨化性纤维瘤的X线和CT表现，比较X线和CT对非骨化性纤维瘤的诊断价值。方法回顾分析经手术及病理证实的12例非骨化性纤维瘤的临床及影像学资料，术前12例患者均经X线和CT检查，分析其影像学与病理的相关性。结果肿瘤位于长骨干骺端，股骨4例，胫骨8例。X线和CT分为皮质型和髓腔型，皮质型9例，髓腔型3例。手术证实为非骨化性纤维瘤。结论非骨化性纤维瘤的影像学表现具有一定特征性，X线和CT是诊断非骨化性纤维瘤非常有用的方法。     

股骨纤维组织细胞源性肿瘤及瘤样病变的影像学诊断(附17例分析)

目的探讨股骨纤维组织细胞源性肿瘤和肿瘤样病变的影像学诊断。方法回顾性分析17例股骨纤维组织细胞源性肿瘤和瘤样病变的影像学特征,其中16例经手术病理证实,1例非骨化性纤维瘤(皮质型)经随访证实。均行X线平片检查,5例同期行CT检查。结果骨纤维结构不良8例,非骨化性纤维瘤5例,骨纤维肉瘤与良性纤维组织细胞瘤各1例,恶性骨纤维组织细胞瘤2例。17例中13例于手术前获得正确诊断,正确诊断率76.5%(13/17),4例误诊。结论股骨大多数纤维组织源性病变因其有特殊的影像学所见,手术前正确诊断;而股骨纤维组织细胞源性肿瘤因缺乏影像特异所见,故诊断时必须结合临床和病理资料。     

颅面骨纤维异常增殖症的影像病理学表现

目的 探讨颅面骨纤维异常增殖症的影像表现和病理特点.方法 回顾性分析42例经手术病理证实的颅面骨纤维异常增殖症,对其影像学表现和病理特点进行对比分析.结果 42例中单发型35例,多骨型7例.磨砂玻璃状改变是骨纤维异常增殖症特征性CT表现,占CT检查患者的79.3%,纤维异常增殖症的病理成分纤维和纤维样组织,在磁共振的T_1WI和T_2WI上均表现为低信号;如病灶发生出血、坏死或囊变,T_2WI信号也随之发生改变.结论 CT和MRI扫描对颅面骨纤维异常增殖症的诊断具有重要意义.     

肺癌脊柱骨转移ECT检查76例分析

目的:探讨肺癌脊柱骨转移患者全身静态骨显像(ECT)的特点及规律。方法:收集用ECT检查发现的35~85岁肺癌脊柱骨转移76例患者临床资料,将其分为49岁以下组及50岁以上组(包括50岁),分析其临床特点及ECT表现,并结合X线检查结果分析其早期诊断优势。结果:50岁以上组61例,占80.3%;49岁以下组15例,占19.7%;76例脊柱转移患者中50例为多发病灶(占65.8%),26例为单发病灶(占34.2%)。转移灶尤以胸腰椎最多见。全组病例的78.9%表现为溶骨性破坏,14.5%表现为蜂窝状溶骨性骨破坏,5.3%表现为小片状、斑片状成骨性改变,1.3%表现为斑片状溶骨及成骨混合性改变。结论:肺癌脊柱骨转移的发生有一定的规律及特点,较之X线检查,核素全身骨显像对于肺癌脊柱骨转移的早期临床诊断及治疗决策有重要的意义。     

髂骨原发囊样骨肿瘤及瘤样病变的影像学诊断

目的:分析髂骨囊样骨肿瘤及肿瘤样病变的影像学表现。方法:回顾性分析经穿刺或/和手术病理证实的46例髂骨囊样骨肿瘤及肿瘤样病变影像学表现。46例全部行X线片检查,38例行CT检查,20例行MRI检查(增强16例)。结果:46例中骨肿瘤29例,其中良性肿瘤12例(骨巨细胞瘤4例,内生软骨瘤、软骨母细胞瘤各2例,血管瘤、骨母细胞瘤、骨样骨瘤、软骨黏液样纤维瘤各1例),恶性肿瘤17例(恶性巨细胞瘤、骨恶性纤维组织细胞瘤各1例,软骨肉瘤、淋巴瘤各4例,骨肉瘤7例),肿瘤样病变17例(单纯性骨囊肿1例,邻关节骨囊肿、动脉瘤样骨囊肿、嗜酸性肉芽肿各2例,骨纤维异常增生症10例)。发病部位为髂翼39例,髋臼7例。病变主要表现为髂骨囊样骨质破坏,呈膨胀性改变30例,硬化环形成24例,病变内见钙化灶14例,软组织肿块20例。结论:常见的髂骨囊样骨肿瘤和肿瘤样病变一般都具有某些特征性的CT表现,必要时综合X线、MRI表现,可提高定性诊断符合率。     

颅底及面部骨纤维病变的影像学分析

目的 探讨颅底及面部骨纤维病变的CT和MRI诊断及鉴别诊断价值,提出术后影像学随访的重要性. 资料与方法回顾性分析经临床病理和组织学活检证实的颅底及面部20例骨化性纤维瘤和23例骨纤维发育不良患者的CT和MR影像学资料,并对两类病变共计27例进行术后影像随访.结果 20例骨化性纤维瘤中,18例为单骨发病,2例为多骨病变.CT表现为椭圆形或分叶状稍高密度肿块,边界清晰,瘤周有一层较完整或不完整的骨性包壳.内部呈不均匀密度13例,均匀磨玻璃样密度7例,其中11例有明显囊变坏死区;11例MR T_1WI以等、低信号为主,T_2WI以等、高信号为主,11例增强后间隔和实性部分强化.23例骨纤维发育不良中,多骨型20例,单骨型3例,无明确边界,密度均匀或不均匀,骨皮质变薄、模糊,骨质周围无软组织肿块和骨膜反应.5例MRT_1WI、T_2WI均以等、低信号为主,信号不均匀.结论 颅底及面部骨化性纤维瘤和骨纤维发育不良有相似的临床、病理特点,影像学有一定特征,有助于诊断和鉴别,部分病例两者鉴别困难.术后影像学随访以CT为主,MRI对需要再次手术者为重要补充.     

The role of bone scan in the diagnosis of Jaffé-Lichtenstein-Uehlinger syndrome

The case of a 12-year-old girl with Jaffé-Lichtenstein-Uehlinger syndrome is presented. A bone scan pattern exhibits clinical symptoms, X ray images and histological findings are described in a case of polyostotic form of the fibrous dysplasia. A biopsy with histology was performed in consideration of bone scan findings and a confirmed final diagnosis.