非骨化性纤维瘤的X射线及CT表现特征分析

Imaging characteristics of non-ossifying fibroma on X-ray films and CT

目的探讨非骨化性纤维瘤（non-ossifying fibroma,NOF）的X射线及CT表现特征。方法搜集12例经手术病理证实的NOF患者的X射线及CT资料,根据影像表现进行分型,分析并归纳影像特征,讨论影像学的鉴别诊断,总结不同影像检查的优势。结果 12例均做X射线平片检查,5例做CT检查。病变发生于干骺端8例,骨干4例;4例发生于膝关节周围,3例发生于股骨颈;病灶长度为2.0～9.8 cm。X射线表现分为皮质型（6例）和髓腔型（6例）;病灶多为囊性低密度区,部分伴硬化、分隔,周围骨皮质轻度膨胀及变薄;髓腔型病灶一般较皮质型更大,边界更模糊。CT观察可见细小骨嵴及边缘硬化线。1例合并病理性骨折,CT显示更清楚。结论 NOF的X射线及CT表现有一定特征,提高对本病的认识有助于提高术前诊断的准确性。NOF除多发于膝关节附近以外,还常发生于股骨颈区域,可伴有病理性骨折。

Objective To investigate the imaging features of non-ossifying fibroma（NOF） on X-ray plain film and computed tomography（CT）.Methods Data of X-ray and CT of 12 patients with NOF that had been confirmed by pathological examination were collected.Classification was made according to imaging findings.Image characteristics were analyzed.Imaging differentiation diagnosis was explored.Advantages of each imaging examination were summarized.Results The all 12 patients with NOF had X-ray examination and 5 cases had CT scans.There were 8 cases whose lesions were found in the metaphysis and 4 in the diaphysis,4 cases around knees and 3 occurred in femoral necks.The lesion sizes were from 2.0 to 9.8 cm.The X-ray features could be classified into cortical type（n= 6） and medullary canal type（n = 6）.The lesions of NOF mostly presented as cystic hypointense areas in which some with sclerosis,septation,slight expansion and thinning of adjacent bones.Medullary canal types tended to have larger lesions and more blurry borders than cortical types.The CT scans exhibited fine bone ridges and marginal sclerotic lines.One case was complicated with pathological fractures,which showed better on the CT scan.Conclusion NOF has certain imaging features on X-ray plain film and CT scans.Better understanding of that could facilitate the accurate of pre-operational diagnosis.NOF frequently occurs around knees as well as femoral necks with the possibility of pathological fractures.