骨样骨瘤的影像学表现及诊断价值分析  

Imaging appearances and its diagnostic value of osteoid osteoma

作　　者：杨静[1,2] 张斌青[1,2] 刘玉珂[1,2] 郭会利[1,2] 李培岭[1,2] 张敏[1,2] 

机构地区：[1]河南省洛阳正骨医院 [2]河南省骨科医院影像中心,河南洛阳471002

出　　处：《中国中西医结合影像学杂志》2015年第1期13-15,18,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的：分析骨样骨瘤的X线、CT、MRI及SPECT-CT融合图像的表现,总结其影像学特征。方法：对我院经手术或穿刺病理证实的28例骨样骨瘤的影像学表现进行回顾性分析。25例行X线检查,20例行CT检查,7例行MRI检查,9例行SPECT-CT图像融合。结果：28例均出现大小不一的圆形或椭圆形瘤巢,直径为2.3~19.5mm,瘤巢周围伴有不同程度的骨质硬化。X线对瘤巢显示率为48%（12/25）,4例瘤巢中心出现钙化;CT对瘤巢显示率为95%（19/20）,出现钙化者16例,2例显示＂血管沟征＂;SPECT-CT融合图像,9例瘤巢均有显像剂团状异常浓聚,呈＂太阳征＂;MRI对瘤巢显示率为57%（4/7）,7例均显示不同程度骨髓水肿。结论：瘤巢是确诊骨样骨瘤的关键,CT是发现瘤巢的较好方法,SPECT有利于发现隐匿性病变,SPECT-CT融合图像可以明确病变及其累及的范围。Objective：To analyze the imaging appearances and to evaluate the diagnostic value of X-ray,CT,MRI and fusion imaging of SPECT/CT in osteoid osteoma. Methods：Imaging features of 28 cases of osteoid osteoma proved by surgery and pathology were analyzed retrospectively. 25 cases underwent X-ray,20 cases underwent CT,7 cases underwent MRI and 9 cases underwent image fusion of SPECT/CT. Results：The circular or oval nests were revealed in 28 patients,the diameter of nests ranged from 2.3 mm to 19.5 mm,the margin was clear and with different bone sclerosis surrounded it. X-ray：nests were seen on plain film in 12 cases,4 cases showed calcification. CT：nests were demonstrated in 19 of 20 cases,16 cases showed calcification,2 cases showed ＂vascular groove sign＂. SPECT/CT：nests showed the imaging agent over concentration in 9 cases,concentration was the most in the center but decreased progressively around it,all 9 cases showed ＂sun sign＂. MRI：nests were seen in4 of 7 cases（4/7）,7 cases showed different degrees of bone marrow. Conclusions：Nest is the key in diagnosis of the osteoid osteoma. CT scan is the more accuracy method to demonstrate the nests. SPECT can discover the occult nidus. SPECT/CT can show nidus clearly and define the boundary of the disease.

关 键 词：骨瘤 骨样 体层摄影术 发射型计算机 单光子 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44