骨样骨瘤的MSCT诊断与CT引导下切除的疗效分析  

Diagnostic Value of MSCT in Osteoid Osteoma and the results of CT-guided percutaneous removal of Osteoid Osteoma

作　　者：郑芸[1] 杨贤卫[1] 冷晓明[1] 朱丹[1] 许焕奇[1] 

机构地区：[1]广州中医药大学第一附属医院影像科

出　　处：《中国CT和MRI杂志》2011年第2期61-64,共4页Chinese Journal of CT and MRI

摘　　要：目的分析骨样骨瘤的CT表现并探讨其诊断及治疗价值。方法回顾性分析12例经手术病理证实的骨样骨瘤,12例均行普通X线及CT检查,其中3例同时行MRI检查,分析比较X线、CT和MRI对瘤巢及瘤巢周围骨质改变的显示能力。结果瘤巢均表现为圆形或卵圆形透亮区,直径小于20mm,8例中心可见钙化,呈牛眼征。4例呈环征。瘤巢周围可有不同程度的骨质硬化、骨膜反应、骨髓水肿、软组织肿胀及相邻关节腔积液。CT术前诊断正确11例(91.7%),普通X线术前诊断正确7例(58.3%),3例MRI检查中1例增强扫描术前诊断正确,2例平扫只提示诊断。7例行CT导引下瘤巢毁损,5例CT引导定位后手术治疗,追访6个月-3年未见疼痛复发及明显并发症。结论瘤巢是骨样骨瘤的特征性表现,CT对瘤巢显示最准确,MRI则对显示瘤巢周围骨髓、软组织及关节腔情况敏感。CT引导下经皮穿刺切除骨样骨瘤是一种简单有效、安全可靠的微创性治疗方法。Objective To analysis the appearances and to evaluate the diagnostic value of CT imaging in osteoid osteoma. Methods 12 cases of osteoid osteoma proved by surgical pathology and their X-ray,CT and MRI were re-viewed. All atients had X-ray and CT scanning,3with MR imaging. The ability of X-ray,CT and MRI to demonstrate the nidus and surrounding reaction were analyzed. Results The nidus were appeared as round or oval shape and the diameter was less than 20mm. 8 nidus manifested as 揳ncox eye？sign of calcification in focuscenter. 4 nidus manifested as an ringsign without calcification in focuscenter. There were different degree of bone sclerosis,periosteal reaction and soft tissues or bone marrow edema around the nidus. The diagnostic accuracy was 58.3% for X-ray,91.7% for CT. Accurate diagnosis was obtained before surgery in 1case of MRI,the other 2 cases were only suggestive of the diagnosis.CT-guided percutaneous excision had undergone in twelve patients with osteoid osteoma.In the follow-up of 6-36months, all the patients were pain free without severe complicationes. Conclusion The typical appearances in osteoid osteoma is the nidus,CT scan is the most accuracy method to demonstrate the nidus. The display of bone morrow and soft tissue edema or distinct effusion of joint is highly sensitive by MRI.CT-guided percutaneous removal of osteoid osteomas is safe and effective.

关 键 词：骨样骨瘤 体层摄影术 X线计算机 

分 类 号：R814.4[医药卫生—影像医学与核医学] R738.1[医药卫生—放射医学]