手部内生软骨瘤的X线平片、CT与SPECT-CT影像表现  

X-ray, CT and SPECT-CT performances of enchondroma in hands

作　　者：郭树农[1] 郭会利[1] 魏晓艳 

机构地区：[1]河南省洛阳正骨医院影像中心,河南洛阳471002 [2]河南省洛阳市第五人民医院

出　　处：《实用放射学杂志》2013年第1期96-99,共4页Journal of Practical Radiology

摘　　要：目的 探讨手部内生软骨瘤的影像学表现，分析其影像学特征，提高对本病的认识。方法 结合临床病例和文献资料回顾性分析22例发生在手部的内生软骨瘤影像学表现，22例X线平片检查，6例CT检查，1例SPECT-CT检查。结果22例中，单发18例，多发4例，共累及指骨和掌骨28块。①X线平片表现：病灶呈囊状透亮影，内有钙化及骨嵴，边界清楚，有硬化边，病灶有不同程发膨胀及骨皮质变薄，6例出现病理性骨折，无明显骨膜反心。②CT表现：病灶内呈软组织密度，内有钙化，病灶边界清楚，有硬化边，骨皮质可见筛孔样改变及局部溶解消失，无骨膜反应及软组织肿块。⑧SPECT-CT表现：第2指骨近节、第3指骨近节及中节、第2掌骨病灶呈不同程度放射性核素异常浓聚，其中病灶内钙化、骨嵴及硬化边放射性核素浓聚明显，而非钙化的瘤体区无明显放射性核素浓聚。结论 手部内生软骨瘤有特征性影像学表现，X线检查结合临床可做出明确诊断，CT能发现病灶内特征性的改变，SPECT-CT的应用为临床治疗及术前评估提供了重要的参学依据。Objective To investigate the imaging findings of enchondroma in the hand, and to improve the awareness of this dis- ease . Methods 22 cases with enehondroma in hands were performed X-ray examination. Among them , 6 cases were CT examina tion and one ease was underwent SPECT-CT examination . Their clinical and literature data were retrospectively analyzed . Results Among the 22 cases, 18 cases were single lesion, four cases appeared as muhiple lesion that involved a total of 28 phalanx and meta- carpal. ①X-ray performances： the lesions were cystic translucent shadow with calcification, bone crest, clear botmdaryand harden ing side. The lesions have different degrees of expansion and cortical thinning. Six cases presented pathologic fractures, with no sig- nificant periosteal reaction. ② CT manifestations： the lesions showed soft tissue density, with calcification, hardened side, the le- sion boundary was clear. The cortical bone showed sieve-like changes, partial dissolution disappeared and no periosteal reaction and soft tissue mass. ③ The performance of SPECT CT：the second proximal phalanx, the third proximal phalanx and the second meta- carpal bone lesions showed abnormal radionuclide uptake. Conclusion The enchondroma in hand presents characteristic imaging find ings. Combined with clinics, a clear diagnosis can be made according to X-ray examination. CT can find the characteristic changes within the lesion.

关 键 词：内生软骨瘤 放射摄影术 计算机体层成像 单光子发射计算机断层成像 

分 类 号：R738.3[医药卫生—肿瘤] R814.41[医药卫生—临床医学]