跟骨病变的影像学诊断

The Imaging Diagnosis of Calcaneus Diseases

目的评价跟骨病变的影像学表现。资料与方法回顾性分析经穿刺和手术病理证实的25例跟骨病变影像学表现,其中7例感染性病变(松毛虫感染1例,慢性骨髓炎3例,Reiter’s病1例,结核2例),14例良性肿瘤和肿瘤样病变(骨囊肿4例,动脉瘤样骨囊肿3例,成软骨细胞瘤、血管瘤、内生软骨瘤、软骨黏液样纤维瘤、巨细胞瘤、巨细胞瘤伴动脉瘤样骨囊肿和脂肪瘤各1例),4例恶性骨肿瘤(骨肉瘤和软骨肉瘤各2例)。25例均行X线平片检查,16例行CT检查,8例行MRI检查。结果14例良性肿瘤和肿瘤样病变中11例发生于跟距关节下方,部位较具特征性。感染性病变和良、恶性骨肿瘤影像表现各异,具有各自的相对特征性。结论结合病变部位和平片、CT及MRI综合表现可对跟骨病变进行比较准确的定性。

Objective To evaluate the imaging features of calcaneus diseases. Materials and Methods The imaging features of 25 cases with calcaneus disease confirmed by operation and pathology were reviewed retrospectively, including 7 cases of infectious diseases （ 1 case of pine caterpillars infectious disease, 3 cases of chronic osteomyelitis, 1 case of Reiter disease and 2 cases of tuberculosis ）, 14 cases of benign tumors and tumor-like lesions（ 4 cases of bone cyst, 3 cases of aneurysmal bone cyst, 1 case of cbondroblastoma, angioma, enchondroma, chondromyxoid fibroma, giant cell tumor, lipoma and giant cell tumor accompanying aneurysmal bone cyst, respectively ） , 4 cases of malignant tumors （ 2 cases of osteosarcoma and cbondrosarcoma, respectively ）. All of 25 cases were performed X-ray examination, 16 cases were examined by CT and 8 cases were taken by MRI. Results 11 cases of 14 benign tumors and tumor-like lesions were located under talocalcaneal articulation, the location was characteristic. The imaging features of infectious diseases, benign and malignant tumors were different with relatively characteristic features. Conclusion The combination of location with X-ray, CT and MRI features can correctly diagnose most of calcaneus diseases.