颌骨造釉细胞瘤的CT诊断及鉴别诊断

目的探讨颌骨造釉细胞瘤的CT表现,提高对颌骨造釉细胞瘤的诊断及鉴别诊断能力。方法回顾性分析14例经手术病理证实的颌骨造釉细胞瘤的CT表现。结果 13例位于下颌骨,1例位于上颌窦牙槽突部。单房型8例,呈单房膨胀性骨质破坏,边界清楚,骨壳完整或不完整,内未见骨嵴影,壁可见小嵴状突;多房型6例,表现为多房皂泡状,骨壳菲薄,部分中断,内部不均匀,可见条状骨嵴影。根据肿瘤密度分囊性型、实性型及囊实性型。囊性型6例,呈均匀低密度,CT值为12～25HU,增强扫描囊壁可见轻度强化;实性型2例,呈不均匀中等密度,CT值约30～50HU,增强扫描后呈不均匀强化;囊实型6例,密度混杂,增强扫描可见实性部分明显强化。结论造釉细胞瘤的位置、骨质破坏特点、内部密度特点、生长方式等方面有一定特点,CT有助于该肿瘤的诊断及鉴别诊断。

Ameloblastoma of the jaw: CT diagnosis

Objective To study the CT findings of ameloblastoma of the jaw. Methods The CT features of 14 cases of jaw ameloblastomas were retrospectively analyzed. Results Of the 14 cases, 13 were located in the mandible and 1 in the maxilla. CT showed unilocular expansile lesions with well-defined margins and partial or complete bony shall, no sequestrum in 8 lesions. Six lesions were multilocular and expansile with sequestrum and thin bony walls. The tumors were classified according to the lesion density as cystic, solid and mixed types. Six lesions were cystic with homogeneously low density of 12-25 HU. Two lesions were solid with intermediate density of 30-50 HU and heterogeneous contrast enhancement. Six lesions were cystic-solid with mixed density and heterogeneous contrast enhancement of the solid component. Condusion There are characteristic CT features of ameloblastomas in terms of location, bone destruction, inner structures and growth behaviors that are helpful for diagnosis.