螺旋CT及三维重建在颌骨造釉细胞瘤中的应用  

Value of three-dimensional spiral CT imaging in ameloblastomas of the jaw

作　　者：蔡惠芳[1] 张同华[1] 陈建新[1] 胡翼江[1] 王兆平[1] 李玉洁[1] 徐正道[1] 陈瑛[1] 丰宇芳[2] 丁卫华[3] 

机构地区：[1]江苏省张家港市第一人民医院影像中心,江苏张家港215600 [2]江苏省张家港市第一人民医院病理科,江苏张家港215600 [3]江苏省张家港市第一人民医院口腔科,江苏张家港215600

出　　处：《肿瘤影像学》2014年第1期61-64,共4页Oncoradiology

摘　　要：目的探讨螺旋CT及三维重建在颌骨造釉细胞瘤中的应用价值。方法回顾性分析11例经手术病理证实的颌骨造釉细胞瘤,均行螺旋CT扫描并行三维重建后处理,观察病变的部位、形态、内部结构及邻近结构侵犯等特征。结果 11例患者中,5例病灶位于下颌磨牙区、4例位于下颌体部、2例位于上颌骨。多房型6例,其中3例呈肥皂泡状、3例呈蜂窝状。骨性房间隔可完整或不完整。单房型5例。5例有不同程度牙根吸收。11例病灶均可见周围骨质呈膨胀变薄。7例病灶可见囊壁周围骨质缺损,无硬化缘;2例穿破邻近骨皮质形成软组织肿块。1例侵及上颌窦,5例侵及下颌管。6例病灶呈均一囊性密度,4例呈软组织密度,1例术后10年复发病例呈囊实混杂密度。结论螺旋CT三维成像可直观了解病变在三维立体空间的实际大小、形态、位置、内部结构、周围骨质破坏、牙根吸收及周围组织结构的立体解剖关系,对提高造釉细胞瘤的术前诊断正确率有重要价值,为制订手术方案和放疗计划提供了客观依据。Objective To evaluate the application value of three-dimensional （3D） spiral CT in ameloblastomas of the jaw. Methods A total of 11 patients with ameloblastomas of the jaw confirmed by opreation and pathology were analyzed retrospectively. The location, shape, inner and adjacent structures, and density of lesions were analyzed. Results Among 11 cases, 5 lesions were located in the mandibular third molar region, 4 in mandibular body, 2 in the upper jaw, 6 lesions were multilocular, with ‘soap bubble’ appearance in 3 and ‘honeycomb’ in 3, 5 lesions were unilocular. The lesions showed destroyed adjacent cortex in 7 cases and formed soft tissue mass in 4 cases. Root resorption of tooth appeared in 5 cases. The adjacent vital structures （such as mandibular canal, maxillary sinus and nasal cavity） were always invaded by the lesions. Conclusion Ameloblastomas of the jaw have characteristic manifestations on CT. 3D spiral CT can show the lesion’s size, shape, location, inner structure, disruption of adjacent cortex, root resorption, and complex anatomic relationship with adjacent tissues, and provide information for preoperative evaluation.

关 键 词：造釉细胞瘤 颌骨肿瘤 计算机断层扫描 三维 

分 类 号：R445.4[医药卫生—影像医学与核医学]