牙瘤的临床病理特征及其影像表现

Clinicopathology and imaging findings of odontoma

目的探讨牙瘤的临床病理特点及影像表现,以提高对本病的认识。方法回顾性分析16例经手术病理证实为牙瘤患者的临床病理资料及影像表现。13例行曲面断层全景摄影,16例行CT平扫并行MPR和CPR重建。结果本组16例牙瘤病例中,男9例,女7例,年龄9～18岁,其中混合型牙瘤(OC) 10例,组合型牙瘤(OCp) 6例,肿瘤位于上颔骨10例,下颌骨6例。10例OC中6例发生在上颌骨,4例发生在下颌骨; 6例OCp中发生在上颌骨4例,发生于下颌骨2例。曲面断层X线片和CT均表现为颌骨内类圆形高密度团块,直径1. 3～6. 0cm(平均3. 1cm)。10例OC影像表现为高密度团块影,边界清楚,周围可见低密度透光带,肿瘤内未见牙样结构; 6例OCp肿瘤内均见多发、数目不等的牙样结构。结论牙瘤的影像表现具有一定特征,对临床定性诊断有价值。

Objective To investigate the clinical, pathological and imaging features of odontoma, and to make a further understanding of this disease. Methods Panoramic films and CT manifestations of 16 patients with the histologie diagnosis of odontoma were reviewed. All patients had routine CT examinations, and 13 patients had panoramic radiography. Results A total of 16 odontoma in 16 patients （ 9 males and 7 females,ranged in age from 9 to 18 years） were included. There were 6 compound type odontomas （OCp） and 10 complex type odontomas （OC）. 10 lesions were located in maxilla （OCp 4 cases, OC 6 cases）, and 6 lesions in mandible （ OCp 2 cases, OC 4 cases）. On the panoramic films and plain CT, all the 16 lesions presented with densely calcified mass ranged 1.3 to 6.0 cm in diameter （ average 3.1 cm）. All the 6 eases lesions of OCp showed multiple odontoids. All the 10 eases of OC appeared as a well-defined solitary and homogeneously calcified mass with a radiolueent halo and no odontoids. Conclusion Panoramic radiography and CT features of odontoma are distinctive in eerlain extent, which may be helpful for clinic diagnosis.