骨样骨瘤的数字化X线平片和CT诊断价值

Diagnostic Value of Digital X-Ray and CT in Osteoid Osteoma

目的:分析骨样骨瘤的X线及CT表现,探讨X线、CT,尤其是多排CT的诊断价值。方法:回顾性分析经手术病理和临床证实的骨样骨瘤24例,24例均行X线检查,同时行CT扫描18例;股骨10例,胫骨7例,肱骨3例,颈椎2例,髂骨2例;分析比较X线和CT对瘤巢及瘤巢周围骨质改变的显示能力。结果:X线和CT检查分别有19例和18例表现为一卵圆形或圆形瘤巢,直径<2 cm;管状骨的骨样骨瘤与骨干相邻处骨皮质见骨质硬化;X线和CT的诊断准确率分别为79.2%和100%。结论:骨样骨瘤有特征性X线表现,结合典型的夜间疼痛为主的临床症状一般可明确诊断;CT对瘤巢定位更准确,恰当的CT后处理技术对提高本病诊断准确率有重要价值。

Objective： To identify the diagnostic value of X-ray and CT, especially the multiple detector CT, in osteoid osteoma. Methods： Twenty-four cases of osteoid osteoma proved by surgical pathology and clinical examination were studied retrospectively. Among the 24 cases, all patients had plain X-ray films, and 18 were also examined with CT scanning. Ten cases of osteoid osteomas were located in femur, seven cases in tibia, three cases in humerus, two cases in cervical vertebrae, and two cases in ilium. Results： The imaging manifestations of X-ray and CT in osteoid osteoma revealed a circular or oval nidus with different bone sclerosis around the nidus in 19 cases and 18 cases respectively. The diameter was less than 2.0 cm. In osteoid osteoma of the tubiform bone, the bone sclerosis can be seen closely near the cortical plate of the diaphysis. The diagnostic accurate rate of nidus was 79.2 % for X-ray and 100 % for CT, respectively. Conclusion： Nidus is the key sign in diagnosing the osteoid osteoma correctly in X-ray and CT imaging. Especially combining with the typical main symptom of hypnalgia, the final diagnosis can be made. CT scan is the best method to demonstrate the nidus. Pertinent CT post-processing techniques had important value in upgrading the diagnostic accurate rate in osteoid osteoma.