纤维骨性假瘤的影像学诊断  

Imaging features of fibro-osseous pseudotumor of the hand

作　　者：孙洋[1] 杨旭峰[2] 高振华[2] 彭加友[1] 孟悛非[2] 

机构地区：[1]佛山市中医院CT室,广东佛山528000 [2]中山大学附属第一医院放射科,广东广州510080

出　　处：《影像诊断与介入放射学》2014年第3期234-237,共4页Diagnostic Imaging & Interventional Radiology

摘　　要：目的：分析总结纤维骨性假瘤的影像学表现特点，提高对该病的影像诊断水平。方法回顾性分析5例纤维骨性假瘤的临床影像学资料，包括X线平片检查5例，CT检查4例，MRI检查2例，总结其临床影像学表现特点。结果5例纤维骨性假瘤均发生于掌指骨旁软组织，其中3例发生于拇指，术前临床X线平片检查均误诊，男1例，女4例，年龄15～36岁。3例X线平片和/或CT表现为指骨旁密度均匀或不均匀的骨性肿块，边缘清楚，邻近骨膜新生骨形成，其中1例MRI示骨性肿块信号类似与肌肉信号；1例X线平片和CT表现为骨皮质侵蚀破坏、骨膜新生骨和软组织肿胀，未见肿块；1例X线平片和CT表现为骨膜新生骨和软组织肿胀，无骨质破坏，MRI示类似于肌肉信号的软组织肿块形成。结论纤维骨性假瘤好发于掌指骨旁软组织，常表现为骨旁边界清楚的骨性肿块，伴有邻近骨膜新生骨，骨质破坏少见，应注意避免误诊为骨旁骨肉瘤、骨软骨瘤或骨髓炎。Objective To assess the imaging appearance of fibro-osseous pseudotumor of the hand.Methods The radiographs（5）,CT（4）and MRI（2）of 5 patients（1 man,4 women,age range：15-36 years）with fibro-osseous pseudotumors were retrospectively analyzed.Results All 5 tumors involved the soft tissues adjacent to the metacarpals and phalanges with 3 of which in the thumb.Radiographs and CT on 3 patients showed homogeneous or heterogeneous soft tissue masses adjacent to the phalanges with well-defined margins and adjacent periosteal new bone formation.MRI of one patient demonstrated a bony mass isointense relative to muscle.Radiograph and CT of one patient showed cortical destruction,periosteal new bone,and soft tissue swelling without mass. On another patient,the radiograph and CT demonstrated periosteal new bone,soft-tissue swelling and no bone destruction whereas MRI showed soft-tissue mass isointense relative to muscle.Conclusion Fibro-osseous pseudotumors often involve the metacarpals and phalanges as well-marginated bony masses with neighboring periosteal new bone and rarely bone destruction.These imaging features can help to distinguish them from parosteal osteosarcoma,osteochondroma and osteomyelitis.

关 键 词：纤维骨性假瘤 旺炽性反应性骨膜炎 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738[医药卫生—肿瘤]