成人单发长骨内生性软骨瘤的影像诊断

Imaging of solitary enchondroma of long bones in adults

目的分析成人单发长骨内生性软骨瘤的影像表现特征及分型,提高对该病的诊断水平。方法回顾性分析经手术病理证实15例成人单发长骨内生性软骨瘤的临床及影像资料,15例行X线平片检查,5例行MSCT平扫检查,9例行MR平扫检查。结果 15例成人长骨内生性软骨瘤均为单发;骨端10例(肱骨8例、股骨2例),骨干4例(肱骨1例、股骨3例),股骨颈1例。X线平片三种表现:仅表现为钙化灶3例,骨质吸收伴钙化11例,阴性表现1例;仅3例表现骨膨大。MSCT检查5例,CT对病灶的钙化、周围骨质吸收范围,皮质受侵细节显示优于平片。MR检查9例,病灶境界均清楚显示,包括1例平片阴性,及另一例平片误诊骨化性纤维瘤。结论成人单发长骨内生性软骨瘤以骨质破坏及钙化为主要特征,平片有多种表现,结合X线、CT及MRI可提高诊断准确性。

Objective To analyze the imaging features and classification of enchondroma of long bones in adults, and to improve the diagnostic accuracy of this disease. Methods Clinical and imaging data of 15 adults with solitary enchondroma of long bones confirmed by surgical pathology were studied retrospectively. All 15 patients underwent X-ray examination, 5 patients underwent MSCT scan and 9 patients underwent MRI examination. Results Single enehondromas of long bones were present in all 15 adults, which were located in the proximal humerus in 8 eases, distal femur in 2 cases, femoral shaft in 3 cases, and humeral shaft and femoral neck in 1 case respectively. There were 3 patterns of X-ray findings., calcification only in 3 cases, bone resorption with calcification in 11 cases, and bone expansion in 3 cases. There was negative finding in 1 case. MSCT was performed in 5 cases and was superior to X-ray in demonstration of calcification, bone resorption and cortical infringement. The border of lesions was well demarcated in 9 cases on MRI, including the case which was negative on X-ray film and the other case was misdiagnosed as ossofyong fibroma. Conclusion Solitary enchondroma is characterized by bone resorption and calcification radiographieally. A more accurate diagnosis can be made combining with CT and MRI.