多层螺旋CT在颌骨骨肉瘤诊断中的价值

The value of multi--slice spiral computed tomography in the diagnosis of osteosarcoma of jaw

目的分析颌骨骨肉瘤多层螺旋 CT(MSCT)的影像学特点,探讨 MSCT 在颌骨骨肉瘤诊断中的价值。方法回顾性分析经手术病理证实的10例颌骨肉瘤的 MSCT 表现,男3例,女7例,其中2例有鼻咽部放疗史。结果 10例骨肉瘤中,发生于下颌骨5例,上颌骨5例,表现为溶骨性骨质破坏3例,成骨改变4例,混合型破坏3例。成骨性骨肉瘤均可见放射状骨膜新生骨,7例见不规则、片状瘤骨,在 CT 及 MRI 上软组织肿块均较大,强化明显。MSCT 上通过多种不同的后处理方法能够清楚地显示肿瘤术前及术后颌骨的骨质破坏。结论 MSCT 通过不同的三维重建方法能全方位、直观、详细地显示颌骨骨肉瘤的病灶及其与周围组织结构的关系。

Objective To analyze the radiological features of osteosarcoma of the jaw in multi-slice spiral computed tomography （MSCT）, and determine its values in the diagnosis of the osteosarcoma of the jaw. Methods Totally ten patients with surgically and pathologically proved osteosarcoma were enrolled, including 3 males and 7 females. Two patients had a history of radiotherapy of nasopharyngeal carcinoma. MSCT examinations were performed and imaging features were retrospectively analyzed. Results Among these ten patients, lesions were located in mandible in five patients and maxilla in 5 patients. The lesions demonstrated osteolytic changes in three cases and osteogenesis in four cases and mixed changes in three cases. The periosteum of all the four cases of osteosarcoma osteogenesis showed the sunburst appearance. Irregularity and lamellar tumor bones were seen in seven cases. The lesions of all the ten patients extended into the adjacent soft tissue and manifeswd as a comparatively large soft tissue mass. All lesions showed obviously heterogeneous enhancement, MSCT with the help of 3D reformatting techniques can exactly show the bone destruction and anatomical relation with surrounding tissues. Condusion MSCT can directly and exactly show the details of osteosarcoma of jaw by means of using different 3D image reformatting technique.