骨样骨瘤的影像学表现和诊断价值

Imaging appearances and diagnostic value of osteoid osteoma

目的分析骨样骨瘤的x线、CT和MRI表现，评价它们的价值。方法搜集经手术病理证实的骨样骨瘤22例。分析骨样骨瘤在X线、CT和MRI上的表现及其对瘤巢和瘤巢周围改变的显示能力。结果22例病灶均表现为一圆形或卵圆形的透亮区，直径为0．4-1．0cm，平均0．77cm，其周固有不同程度的骨质硬化。22例X线平片仅17例显示瘤巢，19例行CT检查者均清楚显示瘤巢，X线和CT对瘤巢显示率分别为77．2％（17／22）和100％（19／19），6例MRI检查者仅4例可作出正确诊断。结论瘤巢是骨样骨瘤的特征性表现，CT检查是诊断骨样骨瘤最准确的方法，单凭X线或MRI的表现可能因未显示瘤巢误诊、漏诊，需结合CT可作出准确诊断。

Objective To analyze the appearances and to evaluate the diagnostic value of X-ray ,CT and MRI imaging in osteoid osteoma. Methods Twenty-two cases of osteoid osteoma proved by surgical pathology were collected. The imaging findings of osteoid osteoma and the ability of X-ray, CT and MRI in demonstrating the nidus and the surrounding reaction were analyzed. Reults The imaging manifestations of osteoid osteoma revealed a circular or oval nidus with different bone sclerosis around the nidus. The idameters ranged from 0. 4cm to 1.0cm,with the average of 0.77cm. There were different bone sclerosis around the nidus. Among 22 cases ,only 17 cases showed nidus on plane film. All 19cases with CT scanning showed nidus. The display ratios of nidus were 77.2% for X-ray and 100% for CT,respectively. And 6 cases only 4 cases could be diagnosed correctly on MRI. Conclusion The typical appearances in osteoid osteoma is the nidus. CT scan is the best method to diagnose osteoid osteoma. It is possible to make misdiagnosis only with X-ray or MRI for the case that the hidus not be demonstodted. Combining with CT can make an accurate diagnosis.