畸形性骨炎的影像学诊断  

Imaging diagnosis of osteitis deformity

作　　者：刘玉珂[1] 陈伟[1] 郭会利[1] 张敏[1] 张斌青[1] 杨静[1] 

机构地区：[1]河南省洛阳正骨医院影像中心,河南洛阳471002

出　　处：《实用放射学杂志》2012年第11期1745-1749,共5页Journal of Practical Radiology

摘　　要：目的探讨畸形性骨炎的影像学特征。方法回顾性分析22例经病理证实的畸形性骨炎患者资料，20例行x线检查，13例行CT检查，17例行MRI检查，三者均进行10例。分析X线、CT及MRI表现，总结其影像学特征。结果22例中，海绵型6例，硬化型4例，混合型12例。15例多骨发病，7例单骨发病。X线及CT表现；海绵型以骨质破坏为主，骨皮质膨胀、破坏，呈“丝瓜瓤”样改变，骨髓腔变窄或闭塞消失；硬化型以骨质修复、硬化为主，骨质密度增高，骨皮质增厚，骨小梁粗大，骨髓腔变窄或闭塞；混合型表现为骨破坏与骨质修复混合存在，骨小梁粗大而紊乱，骨质破坏区可见“磨玻璃样”或“大理石”样骨硬化。MRI表现：17例患骨体积增大，骨皮质膨胀、破坏，骨质破坏区呈中等T1、中等T2信号，于脂肪抑制序列PDWI上呈高信号，15例呈“朽木征”，13例骨髓腔变窄。22例均未见明显骨膜反应及软组织肿块。结论畸形性骨炎的影像学表现具有特征性，X线平片是首选的检查方法，CT及MRI是x线平片重要的补充手段。Objective To evaluate the imaging findings of osteitis deformity. Methods The materials of 22 osteitis deformity with pathologically proved were analysed. 20 cases were performed X-ray examination, 13 cases were performed CT scanning, 17 were underwent MRI examination. Among them, 10 cases were underwent all the three examinations. The X-ray,CT,and MRI imaging findings of osteitis deformity were analyzed. Their imaging characteristics were summarized. Results Among the 22 cases,6 cases were spongy,4 cases were sclerosing,and 12 cases were hybrid. 15 cases were multiple bone disease, 7 cases were single bone dis- ease. X-ray and CT findings of spongy osteitis deformity main showed bone destruction, bone cortex inflation, such as ＂vegetable sponge＂, bone marrow lumen narrowed or disappered. Sclerosing main showed osteoselerosis, bone cortex thickening and bone tra- beculae bulky. Hybrid showed bone destruction and osteosclerosis, bone destruction area was visible ground-glass or marble osteo- sclerosis. MRI findings of osteitis deformity showed bone cortex inflation and bone destruction, medium signal on TlWI and T2 WI, high-signal on PDWI. 15 cases showed ＂rotten wood＂ signs, 13 cases showed bone marrow lumen narrowed. 22 cases had not seen obvious periosteum reaction and soft tissue mass. Conclusion Osteitis deformity shows typical imaging appearances, X-ray is the first examination for this disease. CT and MRI are pretty useful in the diagnosis of osteitis deformity.

关 键 词：畸形性骨炎 放射摄影术 计算机体层成像 磁共振成像 

分 类 号：R681[医药卫生—骨科学] R814.42[医药卫生—外科学]