纤维性骨皮质缺损的X线、CT诊断分析

目的:总结纤维性骨皮质缺损的影像学表现特点,加深对本病的认识,提高影像诊断能力。方法:回顾性分析2006～2012年经临床追踪或手术病理证实的28例纤维性骨皮质缺损患者的影像资料。28例均行X线正侧位片检查,其中12例加行病变处切线位片检查,16例行CT检查,分析纤维性骨皮质缺损的X线、CT检查的诊断特点。结果:28例纤维性骨皮质缺损的病灶均位于长管状骨,其中股骨远侧干骺端16例,1例累及双股骨远侧干骺端;胫骨近侧干骺端6例;腓骨近侧干骺端2例;胫骨远侧干骺端2例;肱骨干2例。病灶位于病骨侧后缘20例;位于后缘8例。其典型的影像学表现为:病灶X线正位片呈椭圆形或圆形低密度透亮区,边缘多清晰、锐利,见硬化边;X线切线位片和CT图像示局部骨皮质凹陷缺损、病灶表浅、不深入髓腔、病灶表面未见骨壳。结论:纤维性骨皮质缺损通过X线正侧位片、切线位片和CT图像分析可明确诊断。     

纤维性骨皮质缺损的影像诊断

目的：探讨纤维性骨皮质缺损的各种影像表现，评价X线、CT、MRI对纤维性骨皮质缺损的诊断价值。方法：搜集经临床追踪或手术证实21例患者，其中15例摄X线平片；10例行CT扫描，5例行MRI扫描，分析X线、CT、MRI影像特点。结果：21例共22个病灶，其中股骨远侧干骺端13个，胫骨近侧干骺端6个，股骨近侧干骺端2个，肱骨下干骺端1个。单发20例，对称发生1例。X线表现：病灶呈类圆形、椭圆形、泪滴状或不规则形，骨质缺损区，病灶长轴与骨干平行，边缘可见硬化边，病灶切线位上可见杯口状或碟状的骨皮质缺损，局部未见骨膜反应及软组织肿胀。CT表现：位于骨皮质表层或骨皮质内的不规则骨质破坏区：CT值40-69HU，病灶局部可见骨皮质缺损，内缘可见硬化环。病变均无骨膜反应，周围软组织未见肿胀及钙化。MRI表现：4个病灶在T1WIT2WI上均呈低信号，1个病灶呈T1WI上低信号，T2WI上高信号，边缘皆有更低信号线环绕。19例（20个病灶）经随访观察，11个病灶缩小，8个病灶未见明显变化，1个病灶消失。结论：FCD通过影像检查可以确诊。X线平片是检查的首选方法，但CT、MRI比平片更有价值。     

纤维性骨皮质缺损的影像学诊断

目的分析纤维性骨皮质缺损（FOCD）的X线、CT及MRI表现及其诊断价值。方法回顾分析11例纤维性骨皮质缺损的X线、CT及MRI表现,全部经穿刺活检或手术病理证实。结果纤维性骨皮质缺损发生存股骨4例,胫骨3例,肱骨及腓骨各2例。在X线平片上FOCD病灶表现为三角形或碟形骨质破坏边缘有硬化,CT表现为半圆或三角形骨缺损,内含软组织密度,MRI T1WI上呈低信号,T2WI上呈稍低或低信号。结论X线、CT和MRI可显示纤维性骨皮质缺损的影像特征,并具有较高的诊断价值。     

纤维性骨皮质缺损的影像诊断

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，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0．6～36cm，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，观察随访可了解纤维性骨皮质缺损的转归过程。     

纤维性骨皮质缺损的X线与CT诊断

目的：提高对纤维性骨皮质缺损（FCD）的影像诊断和鉴别诊断能力。资料与方法：搜集经临床追踪诊断或手术病理确诊的有X线和／或CT检查资料的纤维性骨皮质缺损病例，21例均有X线资料，其中6例有CT资料。重点进行影像诊断分析。结果：21例共28个病灶，其中股骨远端18个，胫骨近端5个，股骨近端2个，腓骨近端2个，尺骨1个；单发16例，多发5例；长骨干骺部25个，骨骺边缘3个。X线表现：大小为0．5－3．2cm，平均1．25cm。圆形7个，椭圆形15个，长径均与长骨一致，不规则6个；边界清晰24个，模糊4个；22个可见硬化边，边厚约1mm，6个未见硬化边。病灶内为均匀的低密度，周围未见骨膜反应及软组织肿胀。7个病灶CT表现：位于骨皮质内，轻度向外膨胀1个，3个皮质凹陷，3个膨入髓腔；周围硬化环均完整连续；环内为均匀的软组织密度，均未见钙化灶，2个病灶内可见很细的纵向间隔，2个病灶邻近有轻微软组织肿胀，5个邻近无软组织肿胀。10个病灶经随访观察，无1例发现病灶扩大或出现新病灶，2个病灶无改变，8个病灶可见不同程度的缩小。结论：典型的FCD单凭X线即可诊断，否则应结合发病年龄、临床表现、X线表现及随访改变等综合考虑，CT检查对病变的定位非常明确，对骨皮质的连续性、膨胀性及周围软组织的肿胀、骨膜反应、病灶内部的均匀性；病灶边缘的硬化等的显示较平片更有价值。     

纤维性骨皮质缺损的X线、CT和MRI诊断

目的：探讨纤维性骨皮质缺损的X线、CT和MRI诊断价值。方法：15例全部摄平片，10例行CT检查，5例行MRI扫描；随访1－8年，2例手术病理证实。分析缺损的X线、CT、MRI特点。结果：15例累及18骨，共20个病灶。病灶80％（16／20）位于股骨下干骺端，呈凹向骨髓腔的杯口样或碟形缺损，表面无骨壳，内缘有硬化线，部分缺损内有纵形骨性分隔。4个病灶随访复查消失。结论：X线、CT和MRI能对纤维性骨皮质缺损提供较准确诊断，随访观察可了解缺损的转归。     

非骨化性纤维瘤的临床表现及影像学分析

目的评价X线平片、CT扫描在诊断长骨非骨化纤维瘤中的作用,旨在提高对该病的诊断与鉴别诊断水平。方法对22例经手术病理证实的非骨化性纤维瘤患者的临床及影像资料进行回顾性分析。结果临床症状轻微．好发于长管状骨的干骺或骨干;股骨10例,胫骨8例,腓骨2例;胫腓骨同时发病的2例。皮质型18例,表现为皮质内或紧贴皮质下的单房或多房透亮区,病变向骨内发展突入髓腔,周围有致密的硬化带环绕,以髓腔侧明显;髓质型4例,病灶在骨内呈中央性发展,显示为单房或多房透亮区,边缘有硬化,骨皮质变薄,轻微向周围膨隆。结论术前大部分能够正确诊断;典型病例X线平片即可明确诊断;不典型者需进一步检查,更好地显示病变内部结构及向髓腔发展的情况。     

非骨化性纤维瘤的X线平片及CT诊断(附14例报告)

目的　分析非骨化性纤维瘤的X线平片及CT表现 ,探讨其诊断价值。方法　 14例中男 11例 ,女 3例 ,年龄 9～ 5 1岁 ,均经手术病理证实 ,有完整的X线、CT资料。结果　 10～ 2 0岁发病最多 (占 64.3% ) ,多发生于膝关节附近、股骨及胫骨干骺区。X线表现分为两型 :皮质型 6例 ,髓腔型 8例。CT特征表现为 :( 1)局部骨皮质破坏 ;( 2 )病灶内细而短的骨嵴 ;( 3)病灶近髓腔侧有细的硬化线。结论　X线平片结合CT检查可提高NOF诊断的准确性     

骨肉瘤X线平片、CT和MRI征象对比分析

目的 探讨骨肉瘤X线平片、CT和MRI的表现及其对骨肉瘤的诊断价值.方法 回顾性分析34例影像学资料完整并经病理证实的骨肉瘤,对骨肉瘤同一征象在不同检查方法的表现进行界定、观察、记录及统计学分析.结果 ①X线平片和CT显示瘤骨呈高密度,MRI显示絮状瘤骨6例.2例针状瘤骨在X线和CT不能显示,MRI呈长T1短T2信号.②MRI能显示X线平片和CT不能显示的骨膜反应和骨膜三角9例和4例.③骨皮质破坏:X线平片和CT显示骨皮质破坏的形态.MRI能显示骨皮质破坏的病理基础.④干骺端或骨端松质骨在X线平片和CT呈溶骨、成骨或混合性改变,MRI呈长T1长T2和(或)长T1短T2信号.⑤骨干髓腔病变:X线平片能显示肿瘤骨,CT显示液-液平面3例,MR上,19例能分清肿瘤实质与瘤周水肿.⑥骺板(痕)及骨骺侵犯:X线平片和CT能显示骨质破坏和肿瘤骨,MRI还能显示骺板(痕)及骨骺瘤周水肿.⑦肿块与软组织肿胀:X线平片显示3例有钙化的软组织肿块边缘清楚,而CT和MRI显示软组织肿块均边缘清楚,分别为28例和32例;X线平片不能显示软组织肿胀.结论 X线、CT和MRI在显示骨肉瘤的征象方面各具特点,三者互补可提高诊断的正确率.     

纤维性骨皮质缺损的X线、CT表现和随访研究

目的 研究纤维性骨皮质缺损的X线、CT表现及发病机制和转归。方法 58例全部摄平片，26例行CT扫描，随访2－15年。6例手术病理证实。总结缺损的CT、X线特点，提出病灶愈合的分型。结果 共累及65骨，70个病灶。病灶81．43％（57／70）位于股骨下干骺端，呈凹向骨髓腔的杯口样或碟形缺损，内缘有硬化线，表面无骨壳，部分缺损有纵形骨嵴。18个病灶随访复查消失，根据其表现分为原位骨化型和平复型。3例3个病灶随访增大，手术证实为非骨化性纤维瘤。结论 纤维性骨皮质缺损表面无骨壳，有自愈倾向，亦可长期存在。表现典型及内有骨嵴的缺损未见转化为非骨化性纤维瘤者。     

骨肉瘤病的影像学诊断

目的分析骨肉瘤病的影像学表现，评价影像学的诊断价值。方法总结分析15例骨肉瘤病的影像学特点。15例均行平片检查，其中13例行CT检查，11例行发射型计算机体层摄影(ECT)检查，5例行MR检查。4例行DSA造影检查。结果15例中骨肉瘤病主病灶位于股骨远端者8例，胫骨近端5例，肱骨近端1例，锁骨1例。主病灶之外的多发病灶发生在股骨远端者6例，其中双侧病变2例。位于胫骨近端者8例，骨盆2例，脊柱椎体6例，颅骨1例，髂骨及骶髂关节4例，双侧股骨近端3例，胫骨远端2例。15例主要病变X线表现为典型骨肉瘤样，而发生在其他部位的病灶表现不同，多呈圆形成骨样改变。13例CT观察到病变范围分布及软组织肿块的情况；其中发生在骨髓病变区内的病变多为边缘清楚的高密度瘤骨，5例病变在MRI呈圆形信号改变。特别是髓腔内低信号的骨化区域显示得很清楚。11例ECT检查者可见呈全身分布的广泛浓聚区域。4例于DSA可观察到肿瘤血管边界及肿瘤血管的走行。结论骨肉瘤病为全身的多发病灶，影像学检查可观察全身发病的部位、表现，对疾病的诊断和治疗将提供可靠的依据。     

纤维性骨皮质缺损的磁共振成像与CT诊断

目的 提高对纤维性骨皮质缺损的磁共振成像(MRI)及CT诊断及鉴别诊断能力.方法 收集经临床追踪或手术病理证实的纤维性骨皮质缺损患者11例,11例全部有MRI平扫资料,其中8例有螺旋CT平扫加三维重建,分析其MRI及螺旋CT的影像特征.结果 MRI表现:T2WI高信号或以高信号为主的混杂信号,T:WI低或稍低信号,短时间反转恢复序列(STIR)明显高信号.螺旋CT平扫:表现为皮质内囊状或不规则形、无膨胀性的骨质缺损区,外侧骨壳可完整或缺损,邻近骨质无骨膜反应,灶内为均匀软组织密度影,未见钙化灶.随访8个病灶无改变,7个病灶消失.结论 纤维性骨皮质缺损属常见良性病变,MRI及CT能进行准确诊断,有较高的临床应用价值.     

非骨化性纤维瘤的临床及影像学分析

目的 探讨非骨化性纤维瘤(NOF)的临床及影像学特征，以提高诊断水平。资料与方法 分析经病理证实的NOF14例，所有病例均作X线平片检查，3例同时作CT检查。结果 临床症状轻，好发于长管状骨的干骺区或骨干；股骨5例，胫骨8例，胫腓骨同时发生1例。皮质型12例，表现为皮质内或紧贴皮质下的单房或多房透亮区，病变向骨内发展突人髓腔，周围有致密的硬化带环绕，以髓腔侧明显；髓质型2例，病灶在骨内呈中央性发展，显示为单房或多房透亮区，边缘有硬化。骨皮质变薄，轻微向周围膨隆。9例准确诊断，诊断准确率64．29％，3例未定性，误诊2例。结论 NOF术前大部分能够正确诊断；典型病例X线平片即可明确诊断；不典型者需进一步CT检查，更好地显示病变内部结构及向髓腔发展的情况。     

长骨骨干骨肉瘤X线、CT及MRI表现

目的 分析长骨骨干骨肉瘤X线、CT和MRI表现,探讨有关的临床特点和鉴别诊断.方法 28例长骨骨干骨肉瘤患者,均经手术与病理证实,其中病变位于股骨干18例、腓骨干4例、肱骨干4例、胫骨干2例.所有患者均行X线、CT和MR检查,对其影像学表现与手术病理结果进行对照,并由双盲法分析确认.结果 28例中,X线和CT显示广泛骨质破坏16例,骨膜反应22例.X线显示软组织肿块18例,肿瘤骨和瘤样钙化12例.CT平扫显示软组织肿块22例,增强扫描显示软组织肿块24例,肿瘤骨和瘤样钙化16例.MRI显示骨质破坏和骨膜反应10例,软组织肿块26例,其周围可见软组织水肿及骨髓水肿.骨膜反应在SE T1WI上呈等低信号,T2WI呈等信号.软组织肿块在T1WI为等信号,T2WI及STIR呈等高信号.软组织水肿及骨髓水肿在T2WI及STIR呈高信号.MRI增强检查显示病灶均呈不均匀强化,骨髓水肿和软组织肿块均见强化.结论 X线、CT和MRI从不同方面反映长骨骨干骨肉瘤的影像病理特点,其发病率低,骨破坏范围大,无病理性骨折.成骨型骨干骨肉瘤较易诊断,溶骨型应与Ewing瘤、恶性巨细胞瘤等鉴别.

Abstract：

Objective To explore the findings of diaphysial osteosarcoma in long bone on X-ray,CT and MRI, and discuss their clinical features and manifestations for differential diagnosis. Methods Twenty-eight cases with diaphysial osteosarcoma in long bone proved by surgery and pathology were reviewed retrospectively. Eighteen tumors were located in the femur, 4 in fibula, 4 in humerus and 2 in tibia. All of the patients were examined by X-ray, CT and MRI. The imaging manifestations on X-ray, CT and MRI were analyzed, and the relationship of the imaging features with the pathological types was also observed. The imaging signs were correlated with the pathologic findings with a double blind method. Results Of the 28 cases, there were 16 cases with large bone destruction, 22 cases with periosteal reaction on X-ray and CT. On X-ray, 18 cases showed soft tissue mass and 12 cases with neoplastic bone and tumor calcification.While on CT, 22 cases showed soft tissue mass on plain scan and 2 more cases displayed soft tissue mass after the injection of contrast mediun. Sixteen cases showed neoplastic bone and tumor calcification on CT.On MRI, there were 10 cases with bone destruction and periosteal reaction with iso- and hypo-intense on T1WI and iso- signals on T2WI. Twenty-six cases showed soft tissue edema and bone marrow on MRI. The soft mass were iso-signals on T1 WI and iso-hyperintense signals on T2 WI or STIR. The soft tissue edema was found hyperintense signals on T2WI or STIR. The lesions had heterogeneous enhancement especially in bone marrow with edema and adjcent soft tissue. Conclusion The X-ray, CT and MRI can reflect the pathological changes of diaphysial osteosarcoma in long bone from different aspects. Lower incidence, large bone destruction and no pathological fracture were the features of diaphysial osteosarcoma. The osteogenic type is diagnosed easily, but the osteolytic lesion should be differentiated from Ewing sarcoma, malignant giant cell tumor of bone and so on.     

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.     

Imaging features of subperiosteal aneurysmal bone cyst

PURPOSE: To analyze the imaging features of subperiosteal aneurysmal bone cyst. MATERIAL AND METHODS: The imaging material of 6 patients with biopsy-proved subperiosteal aneurysmal bone cyst was reviewed. Evaluation included patient demographics, lesion location and size, radiographic features, and intrinsic characteristics on CT and MR images. Review of histologic specimens was carried out by an experienced musculoskeletal pathologist. RESULTS: All lesions were located at the surface of long tubular bones (femur 3, tibia 2, humerus 1): 3 involved the diaphysis, 2 the dia/metaphysis, and 1 exclusively the metaphysis. Lesion size ranged from 2.5 to 6 cm in maximum diameter. Radiographs and CT images always showed a superficial bone defect, which on radiographs demonstrated irregular margins in 4 cases. All lesions caused an interrupted periosteal reaction (shell 3, trabeculated shell 1, Codman angle 2). MR images always showed a multicystic appearance with a hypointense rim, contrast-enhancing cyst walls, and fluid levels. Edema of adjacent soft tissues was present in all cases. CONCLUSION: Aneurysmal bone cyst in a subperiosteal location can demonstrate an aggressive radiographic appearance. MR imaging appears to be most valuable in the differential diagnosis, since it can demonstrate typical morphological features of the underlying process.     

Clear cell chondrosarcoma: radiographic, computed tomographic, and magnetic resonance findings in 34 patients with pathologic correlation

Objective To describe the radiographic features of clear cell chondrosarcoma (CCCS), including the computed tomographic (CT) and magnetic resonance (MR) findings, and to correlate them with the histopathologic findings.Design and patients A retrospective review was carried out of 72 patients with histopathologically confirmed CCCS. Imaging studies were available for 34 patients: conventional radiographs (n=28), CT scans (n=14), and MR images (n=15). Radiographic studies were reviewed by three radiologists who rendered a consensus opinion; the studies were correlated with the histopathologic findings.Results Of the 34 patients with imaging studies, 30 were male and 4 were female (mean age 38.6 years; range 11–74 years). Twenty-two lesions were in long bones (15, proximal femur; 1, distal femur; 1, proximal tibia; 5, proximal humerus) and 11 were in flat bones (5, vertebra; 4, rib; 1, scapula; 1, innominate). One lesion occurred in the tarsal navicular bone. Typically, long bone lesions were located in the epimetaphysis (19/22) and were lucent with a well-defined sclerotic margin and no cortical destruction or periosteal new bone formation. More than one-third of the long bone lesions contained matrix mineralization with a characteristic chondroid appearance. Pathologic fractures were present in six long bone lesions (4, humerus; 2, femur). Lesions in the proximal humerus were more likely to have indistinct margins (4/5) and extend into the diaphysis. Flat bone lesions were typically lytic and expansile and occasionally demonstrated areas of cortical disruption. Typically, matrix mineralization, when present, was amorphous. MR imaging, when available, was superior to conventional radiographs for demonstrating the intramedullary extent of a lesion as well as soft tissue extension. CT images better delineated the presence of cortical destruction and the character of matrix mineralization patterns. CCCS lesions were typically low signal intensity on T1-weighted images and moderately or significantly bright on T2-weighted images. Areas of lesion heterogeneity on T1- and T2-weighted images and on post-gadolinium T1-weighted images corresponded pathologically to areas of mineralization, intralesional hemorrhage, and cystic changes. Adjacent bone marrow edema was typically absent (12/15) or only minimally observed in a few cases (3/15). No cases examined with MR imaging demonstrated periosteal new bone formation.Conclusions CCCS typically presents radiographically as a geographic lytic lesion located in the epimetaphyseal region of long bones. Most commonly lesions are found in the proximal femur, followed by the proximal humerus. Lesions within the proximal humerus may exhibit more aggressive features. Lesions in the axial skeleton are typically expansile and destructive, often with soft tissue extension and lack of mineralization. MR imaging may show the presence or absence of bone marrow edema.     

成软骨细胞瘤的影像学特征及鉴别诊断

目的:分析成软骨细胞瘤的影像学特征,提高对该病的影像学诊断和鉴别诊断水平。方法:回顾性分析经临床病理证实的12例成软骨细胞瘤的平片、CT和MRI表现。结果:12例中肿瘤位于胫骨近端4例,股骨头3例,股骨远端1例,肱骨头3例.胸椎(Th_3)附件1例。11例长骨病变者发生于骨骺和干骺端8例。骨端3例。主要X线表现为圆形或椭圆形骨质破坏区,边界清晰,8例可见硬化边,3例可见病灶内有点状钙化。7例行CT扫描,显示骨质破坏区边界锐利、硬化,病灶内斑点状或云絮状钙化6例。4例行MRI扫描,病灶于T_1WI上表现为等或稍低信号。T_2WI均呈低信号,其内可见点状高信号,STIR上呈均匀高信号;硬化边呈线样低信号,2例病灶周围骨质内有水肿.3例可见相邻关节囊积液。结论:成软骨细胞瘤的影像学表现具有一定特征性,多数可做出正确诊断。     

骨原发性平滑肌肉瘤的X线、CT表现

目的总结骨原发性平滑肌肉瘤的X线、CT表现,提高对其影像学认识。资料与方法搜集资料完整且经病理证实的骨原发性平滑肌肉瘤10例,回顾性分析其X线、CT表现。结果股骨远侧骨端3例,胫骨近侧骨端2例,胫骨干、股骨干、锁骨、骶骨和髂骨嵴各1例,均为单发病灶,其中溶骨型3例,囊肿型3例,混合型4例。6例见骨梗死灶,4例见骨膜反应,4例合并大小不等的软组织肿块影,1例合并病理性骨折。结论骨原发性平滑肌肉瘤主要发生于长骨骨端,以膝关节附近最为多见,多侵犯单骨。溶骨性骨质破坏区内或周围软组织肿块出现骨梗死灶,有助于对骨平滑肌肉瘤的诊断。