骨样骨瘤的影像学表现和诊断价值

The imaging diagnosis of osteoid ostema and its diagnosis

目的:探讨骨样骨瘤的X线、CT与MR表现。方法:搜集2007年～2009年经手术病理证实的骨样骨瘤60例,其中男36例,女24例,年龄10～41岁,平均26岁。所有病例均行X线检查,其中行CT检查者18例,行MR检查者24例。分析上述3种影像检查对骨样骨瘤瘤巢的显示率。结果:在常规X线检查中60例病灶均是一个卵圆形亮区或者是一个圆形的亮区,直径>5～16mm,在病灶的周围出现骨质硬化现象,只是程度不同而已;其中48例可以看到瘤巢。显示率为80%;18例经CT薄层扫描均可清楚显示瘤巢,显示率为100%;24例行MR检查,其中18例可显示瘤巢,并可见瘤巢周围的软组织肿胀,瘤巢显示率为75%。结论:瘤巢能够确诊骨样骨瘤。对骨样骨瘤进行诊断一般首先选择常规的X射线,对瘤巢显示的方法中最可靠的是CT,其次是MR,虽然MR有某些缺陷,但却可以清楚的显示瘸巢周围的软组织肿胀情况。

0bjective To exlore X-Ray,CT and MR manifestations of osteoid osteoma.Methods the information of 60 cases of osteoid osteoma roved by surgical athology were collected,including 36 males and 24 females aged from 10 to 41 years,the average age is 26 years.All atients had lain films,18 were imaged with CT scanning,24 with MR imaging.The imaging findings of osteoid osteoma and the ability of X-ray,CTand MRI in demonstrating the nidus were analyzed.Results In conventional X-ray examination,20 cases of lesions aeared as a round or oval of translucent zone,diameter of aroximately 5～16 mm,can be seen around the varying degrees of bone sclerosis,tumor nests can be seen in 16 cases,dislay rate of 80%;18 cases by CT scan can clearly show thin tumor nests,dislay rate of 100%;Tumor nests can be seen in 18 out of 24 cases by MR scan,dislay rate of 75%.Conclusion Tumor nests is the keyoint in confirming osteoid osteoma.Conventional X-ray diagnosis of osteoid osteoma is the first examination ste,CT is the most reliable way to show tumor nest,MR is less sensitive than CT in showing tumor nests,but it can clearly show soft tissue swelling situation around the tumor nests.