颌骨肿瘤多层螺旋CT的诊断价值  

Value of multi-slice spiral CT with three-dimensional reconstruction in the diagnosis of neoplastic lesions in the jawbones

作　　者：袁小平[1] 谢榜昆[1] 林笑丰[1] 梁碧玲[1] 张帆[1] 李洁婷[1] 

机构地区：[1]中山大学附属第二医院放射科,广东广州510120

出　　处：《南方医科大学学报》2008年第9期1700-1702,1706,共4页Journal of Southern Medical University

摘　　要：目的探讨多层螺旋CT(MSCT)三维重建在颌面骨肿瘤诊断中的应用价值。方法33例颌面骨肿瘤,其中造釉细胞瘤14例,骨血管瘤8例,骨肉瘤3例,骨化性纤维瘤3例,纤维肉瘤2例,软骨肉瘤2例,粘液瘤1例。术前均行MSCT扫描和三维重建,扫描层厚2 mm,重建方法包括多平面重组法(MPR)、曲面重组(CPR)和容积再现技术(VRT),术后将二维和三维图像与手术所见进行回顾性对照分析和验证。结果33例颌骨肿瘤,二维横断位图像能提供病灶详细的病理影像学特征,而在显示病变骨的形态学改变和邻近结构的空间关系上三维图像优于二维图像。良性病变在CT上多表现为颌骨膨胀性改变,病灶密度不均,边缘光整,类圆形或分叶状;恶性者常有骨质破坏及邻近软组织肿物。结论多层螺旋CT能够明确颌骨肿瘤范围、骨质改变,对疾病的定性诊断、鉴别诊断有重要价值,有助于临床选择合适的治疗方案。二维CT、MPR、VRT及CPR在显示颌骨肿瘤上各有特点,联合应用对临床有重要作用。Objective To assess the value of multi-slice spiral CT （MSCT） with three dimensional （3D） reconstruction in the diagnosis of neoplastic lesions in the jawbones. Methods Thirty-three patients with neoplastic lesions of the jawbones underwent MSCT scanning with 3D reconstruction. Of these patients, 14 had ameloblastoma, 8 had hemangioma, 3 had osteosarcoma, 3 had ossifying fibroma, 2 had chondrosarcoma, 2 had fibrosarcoma, and 1 had odontogenic myxoma. Preoperative MSCT scanning was performed with the slice thickness of 2 mm, and 3D reconstruction of the images was conducted by means of multi-planar reconstruction （MPR）, curved-planar reformation （CRP）, and 3D volume rendering technique （VRT）. The results were compared with those observed during the operations. Results In the 33 cases, the neoplastic lesions of the jawbones were displayed by 2D or 3D imaging and confirmed by intraoperative findings. Two-dimensional imaging allowed better observation than 3D imaging of the deep structures, whereas 3D imaging was superior in visualizing the morphological changes of the compromised bones and the spatial relationship between the tumors and surrounding structures. Two-dimensional imaging and MPR were excellent in revealing the internal structures and pathological changes of tumors, having also better performance in showing the tumors involving the soft tissues. Benign tumors were most visualized as bone expansion changes with well defined ovoid or lobulated borderlines, and malignant ones often resulted in adjacent bony destruction and soft tissue masses. Conclusion MSCT examination is useful in defining the scope of tumor involvement and bony changes to help in the definite diagnosis, differential diagnosis and choice of clinical treatment. Two-dimensional imaging, MPR, VRT and CRP have their respective advantages and limitations in showing jawbone tumor, and their combination can be of great clinical value.

关 键 词：颌骨 肿瘤 多层螺旋CT 三维重建 

分 类 号：R739.8[医药卫生—肿瘤]