长骨非骨化性纤维瘤的CT表现与病理基础

CT Findings of Non-ossifying Fibroma in Long Bones and Their Pathologic Bases

目的 探讨非骨化性纤维瘤的CT表现及其病理基础的相关性。资料与方法 回顾性分析 13例经手术病理证实的非骨化性纤维瘤患者的螺旋CT表现 ,并将之与手术病理对照研究。结果 13例病灶均发生于干骺端 ,表现为累及骨皮质的偏侧性、膨胀性骨质破坏 ,CT值 5 8～ 72HU ,其内可见残留的骨嵴 ;病灶突入髓腔 ,并与之间以菲薄的骨质。多平面重建 (MPR)图像显示病灶沿患骨长轴扩展 ,呈椭圆形。手术直视瘤体为菲薄骨皮质包绕的灰黄色或褐黄色组织 ,镜下由旋涡样排列的梭形细胞、胶原纤维束构成 ,其间散在多核巨细胞和泡沫细胞 ,无成骨组织。结论 螺旋CT能够细致、准确地反映非骨化性纤维瘤的病理学特征。

Objective To investigate the relationship between CT manifestations and pathologic results in non-ossifying fibroma (NOF). Materials and Methods Spiral CT findings in 13 cases with pathologically proved NOF were retrospectively analyzed, and compared with pathologic results.Results All 13 lesions were located at metaphysis, presenting as eccentric expanded bony destruction with the involvement of bone cortex and a CT value of 58～72 HU. Residual osseous tissue could be seen within the tumor. The lesion protruded into marrow cavity and was isolated from the marrow with a thin bony layer. On MPR, the lesion was oval in shape and extended along the longitudinal axis of the bone. Under direct vision, the tumor was yellow-greyish or brown in color. Microscopically, the tumor was consisted of collagenous fiber bundles and spindle cells arranged in whirlpool shape, and among them multinuclear giant cells and foam cells were disseminated. No osteogenic tissue was found within the tumor.Conclusion Spiral CT scans can precisely reflect the pathologic features of NOF.