骨纤维结构不良X线表现分析

目的 找出骨纤维结构不良的X线表现特点。方法 对31例已确诊的骨纤维结构不良的病变部位、范围、病变形态和结构变化等X线平片的表现进行分析。结果 31例中,累及四肢骨的有19例,累及肋骨的4例,累及颅面骨的8例;呈多骨型者四肢骨为26％(5/19),而肋骨和颅面骨为100％(4/4;8/8);四肢骨和肋骨多骨型者病变均发生在同一侧,而颅面骨约有50％的人累及双侧;四肢骨病人中89％的人病灶发生在骨干,而颅面骨均侵犯颅底骨和蝶窦。囊状透光区和膨胀改变发生率分别为83.9％和93.5％;硬化型改变只在颅面骨受累的病人中出现;磨砂玻璃样改变在四肢骨的出现率与颅面骨基本相同;虫蚀样改变在本研究中未发现。结论 累及四肢骨的骨纤维结构不良主要为单骨型,病灶主要在骨干;而肋骨和颅面骨主要呈多骨型发病,颅底骨和蝶窦是较容易受累的部位;多个骨骼发生病变时,四肢骨和肋骨有同侧发病倾向性。就病变形态和结构来说,囊状膨胀改变是骨纤维结构不良的最主要表现,但颅面骨以硬化改变为主要表现。骨纤维结构不良随个体不同和累及部位不同,其X线表现呈多样性改变,同一个体多种X线表现可同时存在。因此,进行骨纤维结构不良的X线确诊需要全面分析。

Roentgenodiagnosis of bone-fibrous dysplasia

Objective To analyze the characteristic appearances on X -ray plain film of bone -fibrous dysplasia. Methods Thirty-one patients with bone-fibrous dysplasia underwent the examination on X-ray plain film of head,neck,trunk,and quadri-limbs.The pathogenic location,the affected-bone number,the diffusible range,the formal and structural change of the lesions in all patients were evaluated together by three experienced radiologists. Results X-ray plain films in all patients revealed the following findings: (1) the pathogenic locations of bone-fibrous dysplasia were found to be the long bone of quadri-limbs in 19 cases (61.3%),costal bone in 4 cases (12.9 %),and craniofacial bone in 8 cases (25.8 %); (2) the affected-bone numbers were found to be multibone affection in 17cases(54.8 %)and monostolic affection in 14 cases (45.2 %),as a mather of fact all costal bone and cranioficial bone were multi-bone affections while in quadri-limbs monostotic affection was more than multi-bone affection i.e.14 and 5 cases,respectively; (3) the diffusible ranges of the lesions were found to be 27 cases (87.1 %) of ip-silateral lesions and 4 cases (12.9 %) of bilateral lesions which were found in cranioficial bone and the lesions exceeded the midline and/or diffused into skull-bases bone or sphenoidal sinuses;(4)the formal and structural changes of the lesions could be divided into the following four types: a)expansive change in 29 cases (93.5 %). b) sacciform change in 26 cases (83.9 %).c)frosted-glass-form change in 11 cases (35.3 %),and d) sclerosing change in 8 cases (25.8 %). Conclusion In the cases of formal and structural changes of the lesions,as we should expect expansive and sacciform changes are the most appearances of bone-fibrous dysplasia but in affected cranioficial bone the sclerosing change is more frequent appearance.Radiographic appearances of bone-fibrous dysplasia are various and variable, probably, a number of findings occur in same time within one patient,therefore,a overall consideration is nec-essary to perform roentgenodiagnosis of bone-fibrous dysplasia.