16层螺旋CT诊断软骨病变的临床分析

16MSCT in the diagnosis of cartilage lesions

目的探讨软骨病变的多层螺旋CT表现及其临床应用价值,提高诊断水平。方法回顾性分析54例共81处软骨病变的CT及临床资料,着重探讨软骨病变的CT表现及其鉴别诊断,结合文献进行归纳分析。结果本组54例中,CT诊断甲状软骨病变6例(4例软骨骨折,2例软骨破坏)、环状软骨病变4例(2例软骨破坏,2例软骨骨折),肋软骨病变40例(共69根),其中软骨骨折38例共61根肋软骨,2例软骨破坏共8根肋软骨。软骨骨折的主要CT征象为软骨连续性中断(100%),软骨钙化片分离或移位(80.33%),断端周围多有软组织肿胀;软骨破坏的主要CT征象为软骨连续性中断,断端较为圆钝,但软骨表面钙化/骨化部分仍保留在软骨正常轮廓内,恶性肿瘤浸润软骨可呈"泥沙样"改变,周围软组织常见肿胀。结论 MSCT对软骨病变检出率高且能清晰显示软骨病变的部位、数目、形态及移位情况,对软骨破坏性病变结合临床病史可于术前作出准确诊断。

Objective To analyze MSCT fingdings of cartilage lesions and to evaluate the value of CT in the diagnosis of cartilage lesions. Methods MSCT diagnosis and treatment of 54 patients with a total 81 cartilage lesions were reviewed. The MSCT manifestation and differential diagnosis of cartilage lesions were discussed emphatically with the related litera- ture. Results Altogether, 54 patients were found to have cartilage lesions including thyroid cartilage fracture （n~ 4）, thyroid cartilage destruction （n= 2）, cricoid cartilage fracture （n= 2）, ericoid cartilage destruction （n： 2）. At the same time,69 costal cartilage lesions in 40 patients were found, including 61 costal cartilage fracture in 38 patients and 8 costal cartilage destruction in 2 patients. The MSCT imaging of cartilage fracture showed mainly discontinuous focal high-density of cartilage with obvious or obscure malposition （100%） and interruption of calcified cartilage malposition or separation （80.33%）. Soft tissue swelling around were often found. The MSCT imaging of cartilage destruction showed mainly dis- continuous focal high-density of cartilage and the margins were smooth and blunt, but calcification / ossification of carti- lage surface part remained in the cartilage of normal profile, malignant infiltration of cartilage can be in the form of ＂sedi- ment samples＂ change, the soft swelling were often found around. Conclusion The MSCT scan not only has a hign detec- tion rate for the cartilage lesions, but also can display the position, number, pattern and displacement clearly, which is a fast and effective approach for the cartilage destruction and fracture.