纤维性骨皮质缺损的X线、CT表现和随访研究  

CT and radiographic appearance of fibrous cortical defect of bone and follow-up study

作　　者：刘红光[1] 曹庆选[2] 卢明花[3] 周丹[4] 李洪江[5] 刘元伟 刘晓亮[1] 

机构地区：[1]山东省胶南市人民医院放射科,266400 [2]青岛市海慈医院放射科 [3]山东省胶南市人民医院病理科,266400 [4]扬州市第一人民医院CT室 [5]江苏省海门市人民医院放射科 [6]青岛市经济技术开发区医院放射科

出　　处：《中华放射学杂志》2002年第7期629-633,共5页Chinese Journal of Radiology

摘　　要：目的　研究纤维性骨皮质缺损的X线、CT表现及发病机制和转归。方法　 5 8例全部摄平片 ,2 6例行CT扫描 ,随访 2～ 15年。 6例手术病理证实。总结缺损的CT、X线特点 ,提出病灶愈合的分型。结果　共累及 6 5骨 ,70个病灶。病灶 81.4 3% (5 7/ 70 )位于股骨下干骺端 ,呈凹向骨髓腔的杯口样或碟形缺损 ,内缘有硬化线 ,表面无骨壳 ,部分缺损有纵形骨嵴。 18个病灶随访复查消失 ,根据其表现分为原位骨化型和平复型。 3例 3个病灶随访增大 ,手术证实为非骨化性纤维瘤。结论纤维性骨皮质缺损表面无骨壳 ,有自愈倾向 ,亦可长期存在。表现典型及内有骨嵴的缺损未见转化为非骨化性纤维瘤者。Objective To investigate the CT and radiographic findings, pathogenesis , and transform of fibrous cortical defect of bone (FCD). Methods Fifty eight cases (47 males , 11 females; mean age 14.1 years) with FCD were examined with radiography , and CT scanning was performed in 26 cases (33 foci), 6 underwent volume scanning and three dimensional (3 D) reconstruction. All cases were followed up for 2～ 15 years. 6 of them were proved by surgery and pathology. Results (1) Number: 65 bones were involved including 70 foci; (2) location: The attack rate of the distal metaphysis of the femur was 81.43 % (57/70). In 63 foci the distance between the focus and epiphseal line/board was less than 30 mm ,and more than 30 mm in 7; (3) Imaging features: FCD presented as oval shadow (in radiograph) or crateriform / dished indentation to bone marrow cavity and separated with sclerous line. The bony shell was not detected on the surface of defect and part of them had longitudinal crest. CT values of the lesions were 37～85 HU (mean 64 HU).The post margin of the defect attached by muscle shadow was 81.88 % (29 / 33) (4) Follow up: 18 foci showed spontaneous obliteration and they were divided into two types according to their appearance: pre site ossification type and smooth restored type. 3 foci enlarged and were proved to be non ossifying fibroma by surgery. Conclusion The surface of FCD doesn′t have bony shell. The defects shows a tendency of spontaneous obliteration or doesn′t change for a long time. Neither typical FCD nor FCD with crest foci transformes to non ossifying fibroma.

关 键 词：纤维性骨皮质缺损 CT 诊断 X线诊断 发病机制 随访研究 

分 类 号：R816.8[医药卫生—放射医学]