长骨骨端囊样骨肿瘤及肿瘤样病变的CT分析

CT diagnosis of cystic bone tumors and tumors-like in long-bone's ends

目的:探讨长骨骨端囊样骨肿瘤及肿瘤样病变的CT诊断价值。材料与方法:对资料完整曾行CT检查并经活检或手术病理证实的长骨骨端囊样骨肿瘤及肿瘤样病变45例进行回顾性分析。结果:45例中骨肿瘤29例,其中良性肿瘤24例,恶性5例,肿瘤样病变16例。良性肿瘤包括:巨细胞瘤12例,软骨母细胞瘤4例,骨样骨瘤、软骨粘液样纤维瘤各3例,内生软骨瘤及骨母细胞瘤各1例。恶性肿瘤包括:恶性巨细胞瘤、软骨肉瘤各2例,纤维肉瘤1例。肿瘤样病变包括:骨囊肿7例,骨纤维异常增殖症6例,动脉瘤样骨囊肿3例。发病部位包括骺板闭合前28例其中骨骺4例,干骺端24例,闭合后骨端17例。主要CT表现为骨端囊样骨破坏,包括膨胀性改变34例伴皮质断裂13例,骨性包壳形成21例,瘤内钙化13例,液-液平2例,骨膜反应及软组织增厚或肿块分别为5例和4例。结论:CT能清晰显示X线平片不能显示的“囊”壁、“囊”内及周围结构的细微表现,因而具有重要的诊断价值,但因表现有重叠,定性诊断有一定限度。

Objective:To evaluate the CT features and differentiation of cyst like bone tumors and tumor like lesions in the end of long bone.Materials and Method:CT examinations of 45 patients with cyst like bone tumors and tumor like lesions in the end of long bone were retrospectively reviewed,and all cases were confirmed by biopsy or operation and pathology.Results:In 45 cases,29 patients had bone tumor,include 24 benign tumors,five malignant tumors and 16 cases had tumor like lesions.The locations of the bone lesions occurred in epiphysis in four cases,in metaphysis in 17 cases,in the ends of long bone after epiphyseal plate closing in 26 cases.CT can effectively show cyst like bone destruction in all cases,among them,expansile lesions in 34 cases with cortex erosion in 13 cases,with sclerotic margin in 21 cases,calcification within the lesions in 13 cases,fluid fluid level in locules in two cases.Besides these,periosteal reaction and soft tissue mass were seen in four and five patients respectively.Conclusion:CT can clearly show cyst wall and structure within the cyst and cyst like lesions which can not be shown by plain film.Consequently,it offers valuable information.But due to the overlapping of these features,specific diagnosis had certain limitation.