摘要
目的分析股骨颈骨样骨瘤的临床及影像特点,提高对本病的诊断水平。方法回顾性分析21例经手术病理证实的股骨颈骨样骨瘤的临床及影像学资料。其中男18例、女3例;年龄7。26岁,中位年龄13岁。所有病例均行常规X线及CT检查,其中同时行CT增强检查10例,行MR检查4例。结果19例表现为髋关节疼痛,其中夜间痛11例,8例服用水杨酸类药物可缓解;另外2例仅表现为跛行。病程2个月至4年6个月,中位时间12个月。X线平片:21例中仅有10例显示瘤巢,18例股骨颈内下方呈不同程度的骨质硬化。CT:21例均清楚显示瘤巢,其中骨皮质型8例,骨膜下型6例,骨内膜型7例;20例骨质硬化均位于瘤巢下方,即髋关节囊外的股骨前内侧骨皮质;“血管沟征”19例。MRI:4例均可显示瘤巢;骨质硬化在各序列上均呈低信号;关节积液3例,骨髓水肿4例,滑膜增厚2例。结论股骨颈骨样骨瘤的临床表现不典型,但其影像表现具有一定的特征性,瘤巢位于关节内,而骨质硬化主要发生于关节外的股骨前内侧骨皮质。CT扫描仍然是显示瘤巢的最佳方法。
Objective To evaluate the clinical and imaging characteristics of osteoid osteoma in femoral neck and to improve diagnostic accuracy of this disease. Methods Twenty-one patients ( 18 males and 3 females, age, 7-26 years, median age, 13 years) with pathologically proven osteoid osteoma of the femoral neck were retrospectively analyzed for their clinical profile and radiologic features. CT and X-ray examinations were performed in all patients, 10 of them performed post-contrast CT scan and 4 of them performed MRI examinations. Results Nineteen patients had hip pain ( pain worse at night in 11, and 8 received salieylates treatment with good response), and 2 patients only with intermittent elaudieation. The duration ranged from 2 months to 54 months (median duration 12 months). X-ray: Nidus was seen on plain film in 10 cases, 18 cases showed different degrees of bone sclerosis of the nidus. CT: Nidus was demonstrated in all cases. Among them, 8 were intracortical, 6 were subperiosteal, 7 were endosteal. Twenty cases showed different degrees of bone sclerosis of the nidus-extra-articular anteromedial cortical surface of the femur neck. Nineteen cases showed "vascular groove sign". MRI : Nidus was seen in 4 cases. Bone sclerosis was low signal on all sequences. Three cases had joint effusion, 4 cases had bone marrow edema, and 2 cases had synovial thickening. Conclusions Although osteoid osteoma of femoral neck has non-specific clinical features, the radiographic findings are usually typical. The nidus of osteoid osteoma is often located within the joint. Bony sclerosis occurs at the area of extra-articular anteromedial cortical surface of the femur neck. CT examination remains an optimal method to identify the nidus.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2012年第11期1006-1009,共4页
Chinese Journal of Radiology
关键词
骨瘤
骨样
股骨颈
体层摄影术
x线计算机
磁共振成像
Osteoma, osteoid
Femoral neck
Tomography, X-ray computed
Magneticresonance imaging