短骨骨样骨瘤的影像诊断

Imaging diagnosis of osteoid osteoma of short bone

目的探讨短骨骨样骨瘤的影像学特征,旨在减少该病的漏诊和误诊。方法选取9例短骨骨样骨瘤的影像学资料,所有病例均经手术病理证实。其中7例行X线摄影(DR)检查,1例行数字化体层摄影检查,7例行CT检查,4例行MRI检查。结果9例短骨骨样骨瘤的瘤巢直径3~9 mm,周围软组织可见明显梭形肿胀。DR和CT检查表现为类圆形低密度瘤巢,周围可见骨质硬化和骨皮质增厚。瘤巢内可出现高密度钙化或骨化,与周围的骨质硬化区间隔以环形透亮区,为本病的特征性表现。压脂T_(2)WI序列可清楚显示瘤巢周围软组织及骨髓水肿。结论短骨骨样骨瘤较为少见,且临床和影像学表现软组织肿胀,因而影像诊断常较为困难,准确识别瘤巢是诊断短骨骨样骨瘤的关键。

Objective To explore the imaging features of osteoid osteoma of short bone in order to reduce the missed diagnosis and misdiagnosis of the disease.Methods We retrospectively analyzed the images of 9 cases of osteoid osteoma in short bone,which were confirmed by surgery.Seven cases underwent X-ray plain film photography,1 case underwent Digital Tomography scan,7 cases underwent CT and 4 cases underwent MRI scan.Results The nest diameter of osteoid osteoma of short bone was 3~9 mm.Obvious spindle swelling was found in surrounding soft tissue.X-ray and CT showed round-like low-density tumor nests with surrounding bone sclerosis and cortical thickening.High density calcification or ossification may occur in the tumor nest,and a circular transparent area was separated from the surrounding sclerotic area,which was the characteristic manifestation of the disease.The fat-pressed T_(2)WI sequence could clearly show the edema of soft tissue and bone marrow around the tumor nests.Conclusion Osteoid osteoma of short bone is rare,and its clinical and imaging manifestations are often atypical,so imaging diagnosis is difficult.Accurate recognition of tumor nests is the key to the diagnosis of osteoid osteoma.