长骨非骨化性纤维瘤的影像诊断

Image Diagnosis of Nonossifying Fibroma of the Long Bones

目的:分析长骨非骨化性纤维瘤(NOF)的影像学表现。材料与方法:收集35例手术病理证实的下肢长骨NOF的影像学表现,其中男23例,女12例,年龄在4.5～38岁,平均年龄16.6岁。全部病例作了X线检查,CT检查11例,MRI 3例。结果:发生于股骨13,胫骨19例,腓骨3例;病变位于皮质内者4例,皮质髓腔者29例,髓腔1例;圆形5例,长圆形18例,分叶12例;肿瘤长径1.0cm～6.5cm,长径>宽径>前后;病变边缘均有硬化,内边缘见骨嵴17例,分隔12例,钙化4例,2例合并病理骨折。平均CT值63Hu,MRI T_2WI见病变组织信号增高。结论:发生于青少年下肢长骨皮质和髓腔局限性伴有硬化边的骨破坏可诊断本病。

Purpose： To studyimage diagnosis of nonossifying fibroma of the long bones. Materials and Methods： lmage findings of 35 cases of nonossifying fibroma of the lower extremities proved by pathology were presented. There were 23 cases of male and 12 cases female, with age ranging from 4.5- 38 years （mean age 16.6 years）. X - ray plain films were obtained in all 35 cases, CT images in 11 cases, and MR.I in 3 cases. Results： The tumor was located in femur in 13 cases, tibia 19 cases and fibula 3 cases. The tumor was found in the cortex in 4 cases, the cortex and medulla 29 cases, and medullar one case. The shape of the tumor was showed a round lesion in 5 cases, oral lesion 8 cases and lobular lesion 12 cases. The longitudinal diameter of the tumor ranged from 1.0cm -6.5cm, the mean longitudinal diameter was longer than that of transverse diameter and anterior- posterior diameter. The tumors were showed a marginal sclerosis in all 15 cases, residual osseous tissues in 17 cases, septum in 12 cases and calcification in 4 cases, Pathological fracture was found in two cases. The mean CT value was 63Hu. The high signal intensity was demonstrated on MRI T2WI. Conclusion： If a tumor is located in cortical and medulla based of the lwoer extremities in youth, which is showed a well defined lytic lesion with sclerotic rind, the diagnosis of nonossifying fibroma will be considered.