长骨纤维结构不良的CT及MRI诊断分析

目的探讨CT及MRI对长骨纤维结构不良的诊断及鉴别诊断价值。方法回顾性分析经病理证实的21例长骨纤维结构不良患者。所有患者均行CT平扫,MRI平扫及增强扫描19例。结果单骨型20例,其中股骨11例,胫骨4例,肱骨3例,尺骨及腓骨各1例;多骨型1例,同时累及同侧股骨及胫骨。CT表现呈磨玻璃样改变11例,囊状膨胀透亮改变8例,丝瓜络样改变2例。对照CT,呈磨玻璃样改变时MRI上T1WI呈等、稍低信号,T2WI呈不均匀等、稍高信号;呈囊状膨胀透亮改变时,T1WI呈低信号,T2WI呈明亮高信号;呈丝瓜络样改变时,T1WI呈不均匀稍低信号,T2WI呈不均匀稍高信号;增强后呈不同程度边缘或片状不均匀强化。结论 CT可显示长骨纤维结构不良的病变范围及细节等,MRI有助于反映病变组织成分,CT结合MRI在纤维结构不良的诊断及鉴别诊断中有重要价值。

Analysis CT and MRI in diagnosis of fibrous dysplasia of long bone

Objective To investigate the value of CT and MRI in diagnosing and differentiating fibrous dysplasia of long bone.Methods The CT and MRI findings of 21 cases with fibrous dysplasia proved by pathology were retrospectively analyzed,of which all cases and 19 cases were performed CT and MRI with contrast-enhanced examination respectively.Results Single bone pattern was found in 20 cases which comprised 11 femurs,4 tibia,3 humerus,1 ulna,and 1 fibula.Multiple bone pattern was found only in one case whose femur and tibia were simultaneously involved.CT manifestations were divided into three types: ground-glass type(n=11) cyst type(n=8) and loofah sponge type(n=2).On corresponding CT findings,ground-glass type appeared iso-hypointensity on T1WI and heterogeneous iso-hyperintensity on T2WI,cyst type appeared hypointensity on T1WI and obvious hyperintensity on T2WI,and loofah sponge type appeared heterogeneous hypointensity on T1WI and heterogeneous hyperintensity on T2WI.On contrast-enhancement MR images,lesions were marginal or patchy heterogeneous enhancement.Conclusion CT can show the scope and detail of the lesions of fibrous dysplasia of long bone,and MRI can reflect the variable pathologic elements of the lesions.CT and MRI have important values in the diagnosis and differential diagnosis of fibrous dysplasia of long bone.