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。

Clinical and Imaging Analysis of Non-ossifying Fibroma of Bone

Objective To improve the diagnosis of non-ossifying fibroma by analyzing its clinical and imaging features.Materials and Methods Imaging findings in 14 patients with pathologically-confirmed non-ossifying fibroma were analyzed. Plain X-ray film was performed in all patients, and additional CT scanning in 3 cases.Results The clinical symptom was mild. The lesions occurred usually at the metaphysis or diaphysis of the long bones. The affected bones included femur (n=5), tibia (n=8), and both tibia and fibula (n=1). Cortical type was seen in 12 cases, presenting as unilocular or multilocular transparent areas within the cortex or tightly beneath the cortex, the lesion had a sclerotic margin, which was more obvious at the marrow side. Medullary type was seen in 2 cases. The lesion was located at the center of the bone and grew centrally. The tumor was manifested as unilocular or multilocular transparent area with sclerotic border and the bone cortex became thinner with slightly expanding on all sides. Correct diagnosis was made in 9 cases (64.29%), unable to identify the lesion's nature in 3 and misdiagnosis in 2.Conclusion Based on the typical X-ray signs of non-ossifying fibroma, correct preoperative diagnosis can be made in most cases. CT scanning should be carried out for the patients whose X-ray manifestations are atypical. CT scans can also display the morphology and the extent of the lesion.