骨样骨瘤的影像学诊断

目的分析骨样骨瘤的X线、CT及MRI表现,探讨其影像学特征。方法搜集经临床及病理证实的骨样骨瘤23例,男19例,女4例。所有病例均行X线检查,其中同时行CT检查者19例,行MR检查者7例,3种检查都进行者6例。分析骨样骨瘤的X线、CT和MRI表现,及其对瘤巢和瘤巢周围改变的显示能力,总结其特征性的影像学表现。结果23例病灶均显示一直径0.2～2.1cm大小不等的圆形或椭圆形瘤巢,边界清楚,边缘骨质不同程度硬化,骨膜反应,骨髓腔及软组织水肿或关节腔积液。24例X线平片17例显示瘤巢,19例行CT检查者均清晰显示瘤巢,7例行MR检查者5例可显示瘤巢,2例需结合X线及CT检查方能肯定诊断。X线、CT及MR对瘤巢的显示率分别为73.9%(17/23)、100%(19/19)及71.4%(5/7)。结论瘤巢是骨样骨瘤的特征性表现,CT检查是诊断骨样骨瘤最准确的方法,X线检查是诊断骨样骨瘤的重要方法,MR检查对显示瘤巢周围骨髓、软组织及关节腔情况非常敏感,仅凭X线或MR的表现易造成误诊、漏诊。

Imaging Diagnosis of Osteoid Osteoma

Objective To analyze X-ray ,CT and MRI findings of osteoid osteoma and to evaluate their imaging characteristics.Methods 23 cases of osteoid osteoma proved by clinical manifestation and surgical pathology were collected ,there were 19 males and 4females.All patients underwent X-ray examination,19 were imaged with CT scanning ,7 were imaged with MRI ,and 6 were examined with all three techniques.X-ray ,CT and MRI imaging findings of osteoid osteoma were analysed.Results A circular or oval nidus was revealed in 23 cases,the diameter of nidus ranged from 0.2 cm to 2.1 cm ,the margin was clear and around the nidus with different bone sclerosis ,periosteal reaction, bone morrow and soft tissue edema or distinct effusion of joint .Of 23 cases ,17 cases showed nidus on X-ray ,all 19cases with CT scanning showed nidus , 5 cases showed nidus in 7 cases with MRI ,the orther 2 cases could be diagnosed correctly bycomparing with X-ray or CT scanning .The display ratio of nidus was 73.9% by X-ray,100% by CT and 71.4% for MRI .Conclusion The typical appearances in osteoid osteoma is the nidus,CT scan is the best method to diagnose osteoid osteoma .X-ray is an important checking method for osteoid osteoma .The display of bone morrow and soft tissue edema or distinct effusion of joint is highly sensitive by MRI .It is easily to make misdiagnosis only with X-ray or MRI .