薄层CT扫描及二维重建在邻关节骨囊肿诊断中的应用价值

Thin-slice CT and 2D-CT for diagnosis of bone cyst adjacent to joint

目的:回顾性分析38例经病理证实的邻关节骨囊肿患者的CT资料,以探讨薄层CT扫描及重建在邻关节骨囊肿诊断与鉴别中的价值。方法:38例邻关节骨囊肿患者均行薄层CT扫描检查,扫描范围包括病灶及病灶邻近的关节,层厚1.25 mm,层距2.5 mm,其中15例进行矢状位和冠状位的重建,以观察病灶是否与关节腔相通,所有病例均经手术病理证实。结果:38例邻关节骨囊肿共50个病灶,30例为单发性,8例为多发性(共20个病灶),其中1例为双侧对称性。病灶位于关节软骨下,低密度,边缘硬化30例,边缘部分硬化8例,表现为病灶边缘的高密度带;24例显示邻近关节面骨皮质可有断裂,表现为关节面下骨皮质中断;15例经Reformate行冠状面及矢状面的重建,结果显示病灶与关节腔相通。结论:薄层CT扫描及2维重建可充分显示邻关节骨囊肿病灶的位置、形态、边缘、邻近关节面骨皮质断裂与否及病灶与关节腔的关系,在邻关节骨囊肿的诊断与鉴别诊断中具有重要的价值。

Objective To evaluate the contribution of thin-slice CT and 2D-CT for diagnosis of bone cyst adjacent to joint. Methods Thirty-eight patients with pathologically proved bone cyst adjacent to joint were enrolled in this study. Slice CT scan was performed in all 38 patients. CT scan included site of bone lesion and adjacent joint. The slice thick was 1.25 ram, and distance between slice was 2.5 ram. Sagittal and coronary view were reconstructed in 15 patients for de- tecting the communication between bone cyst and adjacent joint. Results Of the 38 patients, 30 had solitary lesion, and 8 had multiple lesions. The lesion was underneath the cartilage of joint, low density, round or irregular in shape, with scle- rosing edge （appeared as a high density zone） in 30 cases and partial sclerosing edge in 8 cases. Break in cortex was seen on joint surface in 24 cases. No soft tissue mass and periosteal reaction was seen. Of the 15 cases had sagittal and coro- nary view reconstructed, all showed communication between bone cyst lesion and adjacent joint. Conclusions Thin-slice CT and 2D-CT could demonstrate the site, shape, edge, break of cortex of joint surface and communication between bone cyst and adjacent joint, and is valuable for the diagnosis of bone cyst adjacent to joint.