多层螺旋CT对肋骨骨纤维异常增殖症的诊断价值

Value of Multi-slice Spiral CT in Diagnosis of Fibrous Dysplasia of the Rib

目的:探讨多层螺旋CT(MSCT)对肋骨骨纤维异常增殖症(FDB)的诊断价值。方法:回顾性分析11例经活检或手术病理证实为肋骨FDB的影像学及临床资料,所有病例均行CT平扫检查及三维重建,其中3例行增强扫描。结果:11例中单骨型7例(63.6%),多骨型4例(36.4%);且三维重建图像可清楚显示病变的整体观;病灶内CT表现主要分3种:囊状低密度改变、磨玻璃样改变、斑块状硬化改变,5例(45.4%)三种表现混合存在,单纯囊状低密度改变3例(27.3%),单纯磨玻璃样改变3例(27.3%);3例增强扫描中1例未见明显强化,2例见轻度强化。结论:MSCT及三维重建技术能清晰显示肋骨FDB的整体形态、内部结构及比邻关系,有利于该病的诊断及鉴别诊断。

Purpose： To study the value of MSCT in the diagnosis of fibrous dysplasia of the rib. Methods： The clinical and imaging data were retrospectively reviewed in 11 cases with fibrous dysplasia of the rib proved by biopsy or surgery and pathology. All of them underwent plain MSCT scan and three-dimensional reconstruction, and 3 cases also had enhanced MSCT scan. Results： Seven of 11 cases （63.6%） were of monostotic type, and the others （36.4%） were of polyostotic type. And the three-dimensional reconstruction images could clearly display the integral form of the lesions. Main CT features of the lesions were classified into three types： cystic hypodense in three cases （27.3%）, ground-glass opacity in three cases （27.3%） and plaque-like osteosclerosis, which both types were mixed, existed in 5 cases （45.4%）. Of the 3 cases with enhanced CT scan, the lesions showed with no enhancement in 1 cases and with mild enhancement in 2 cases. Conclusion： MSCT and three-dimensional reconstruction can clearly demonstrate the integral form, internal structure and its neighboring tissue relationships, which play an important role in the diagnosis and differential diagnosis of fibrous dysplasia of the rib.