髋周单发局灶性骨纤维异常增殖症的影像学诊断

Imaging Diagnosis of Focal Fibrous Dysplasia Near Hip Joint

目的 探讨髋周单发局灶性骨纤维异常增殖症(骨纤)的影像学表现及其诊断价值。资料与方法 回顾 性分析经手术病理证实的12例髋周单发局灶性骨纤的影像学表现,所有病例均行X线平片和CT检查,1例行MRI 检查。 结果 12例均为单骨单发局灶性病灶,分别位于股骨颈4例,转子间区2例,转子下区3例和髋臼顶3例。 4例股骨颈病灶呈凸向外上方的半圆形;2例转子间区和2例转子下区病灶呈与股骨长轴一致的纵椭圆形,1例转 子下区病灶为圆形;3例髋臼顶部病灶呈圆形。病变均伴有硬化缘。CT上病灶内为高于肌肉的软组织密度,密度 不均匀,内可见斑点状、絮状钙质样高密度影。MR T1WI上类似肌肉信号,T2WI上信号介于肌肉和正常骨髓之间, 增强扫描T1WI呈较明显均匀强化。结论 髋周单发局灶性骨纤形态规则,伴有清楚硬化缘,内含高于肌肉的软 组织密度和斑点状、絮状钙质样高密度影为其特征,CT能对其作出正确的术前诊断。

Objective To study imaging manifestations of focal fibrous dysplasia near hip joint and their diagnostic value. Materials and Methods The imaging manifestations of 12 cases with focal fibrous dysplasia near hip joint proved surgically and pathologically were analyzed retrospectively. All cases were performed with plain film and CT, and 1 case with MRI. Results 12 cases were solitary radiolucently lesions, 4 lesions were located in the femoral neck, 2 lesions in intertrochanter, 3 lesions in subtrochanter area, and 3 lesions in the acetabulum. All lesions were semicircular （femoral neck）, round（acetabulum） or oval （intertrochanter and subtrochanter）, and had sclerotic rim. Heterogenous density like soft-tissue within the lesion were higher than muscle on CT images with spotted or striple intralesional ossifications. The lesion was shown as intensity similar to muscle on T1WI and hyperintensity on T2WI with marked homogenously enhancement. Conclusion Focal fibrous dysplasia near hip joint is a regularly solitary lesion surrounded with sclerotic rim. The density within the lesion is higher than muscle with spotted or striple intralesional ossifications on CT, it could be diagnosed correctly by CT.