少见部位骨软骨瘤12例影像分析

Imaging analysis of 12 cases of osteochondroma in rare position

目的探讨少见部位骨软骨瘤的临床及影像学特点,提高诊治水平。方法收集我院2007年2月～2011年8月间经手术病理确诊或长期随访证实的发病于少见部位的骨软骨瘤病例12例。对其临床及影像学表现进行回顾性分析。结果发病部位:12例均为单发。其中:颅骨4例,内板1例,外板2例,下颌骨髁状突1例;肩胛骨1例;肋骨2例,前段1例,肋骨头1例;股骨颈1例;指骨2例,趾骨2例。影像学表现本组12个病灶,广基7例,带蒂5例。均表现为突出于患骨表面的不规则形骨性突起,病灶的皮质和髓质为患骨皮质和髓质的直接延续。治疗及愈后:9例行手术切除,术中见肿瘤呈典型的骨软骨瘤结构;另3例随访2年无变化。结论扁骨、不规则骨、短管状骨骨软骨瘤少见,影像学表现具有特征性。在诊疗过程中要想到少见部位发病的可能性,及时进行影像学检查,以免造成不必要的误诊、误治。

Objective To explore the clinical and radiological feature of osteochondroma and to elevate the diagnostic and cure level.Methods 12 cases of osteochondroma in rare position were selected which were finally diagnosed by pathology in our hospital from February 2007 to August 2011.The clinical and radiological findings were analyzed retrospectively.Results All the cases were single onset,inclnding 4 skull cases（1 internal plate case and 2 outer plate cases）,1 mandibular condyloid process case,1 scapula case,2 costal bone cases（1 anterior segment case,1 costal head case and 1 collum femoris case）,2 finger bone cases,and 2 toe bone cases.The radiological manifestations showed that 7 cases had wide base and 5 cases had pedicle in all the cases.It was showed as bone ecphyma on the surface of it,the cortical bone and medullary substance of osteochondroma was directly from the illed bone.Ttreatment and follow up showed that 9 cases cured by operation and appeared the typical osteochondroma structure.The other 3 cases had no change in 2-year follow up.Conclusion The osteochondroma in flat bone,irregular bone,stub-shaped bone is rare and has typical radiological feature.We must consider possibility of this disease in rare position and do the radiological examination in time in the routine medical activity,so can reduce the misdiagnosis and mistreatment.