骨磷酸盐尿性间叶肿瘤的影像表现及文献复习

Imaging Features of Osseous Phosphaturic Mesenchymal Tumor and Literature Review

目的探讨骨磷酸盐尿性间叶肿瘤(PMT)的影像学表现,提高其诊断准确率。方法回顾性分析经本院手术病理证实的7例骨PMT的临床及影像资料,总结其特点。结果7例患者共7个病灶,其中6例位于股骨头关节面下,1例位于股骨转子间骨皮质下,X线表现为局部或全身性广泛骨质软化伴单发或多发病理性骨折,且情况随病程延长而进展,CT表现为结节状或楔形的成骨性病灶,宽基底与关节面或骨皮质相贴,MRI表现为稍长T1、稍长T2病灶并明显强化;实验室检查表现为碱性磷酸酶及尿磷升高、血磷降低,血钙正常。结论股骨关节面下或皮质下的成骨性楔形病灶并明显强化,对骨PMT的诊断具有较高价值。

Objective To investigate the imaging features of osseous phosphaturic mesenchymal tumor and to improve its diagnostic rate.Methods The clinical and imaging data of 7 cases of osseous phosphaturic mesenchymal tumors confirmed by surgery and pathology in our hospital were retrospectively analyzed,and their characteristics were summarized.Results There were 7 lesions in 7 patients,of which 6 were located in the subarticular surface of the femoral head and 1 was located in the subcortical intertrochanteric bone.The X-ray showed local or systemic extensive osteomalacia with single or multiple pathological fractures and the condition progressed with the prolongation of the disease course.CT showed nodular or wedge-shaped osteogenic lesions,with a broad base that was contiguous with the articular surface or cortical bone.MRI showed slightly longer T1 and longer T2 lesions with obvious enhancement.Laboratory examination showed raised ALP and urine phosphate,decreased serum phosphate,and normal serum calcium.Conclusion The osteogenic wedge-shaped lesions under the articular surface or cortex of the femur are significantly enhanced,which is of high value for the diagnosis of ossesous phosphaturic mesenchymal tumors.