颌骨造釉细胞瘤的多层螺旋CT诊断及鉴别诊断  

MSCT diagnosis and differential diagnosis of jaw ameloblastoma

作　　者：吕建成 庄雄杰[2] 吴秀蓉[2] 

机构地区：[1]福建省厦门市口腔医院口腔颌面影像科,361003 [2]厦门大学附属第一医院影像科

出　　处：《实用医学影像杂志》2016年第6期478-480,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨颌骨造釉细胞瘤的多层螺旋CT(MSCT)表现,复习文献,提高对颌骨造釉细胞瘤的诊断及鉴别诊断能力。方法回顾性分析16例经手术病理证实的颌骨造釉细胞瘤的MSCT表现。结合三维重组技术观察病变的部位、形态、内部结构、邻近结构侵犯及囊内容物密度特征等。结果 16例中,13例位于下颌骨,3例位于上颌骨。5例单房,其中2例为单房分叶状,11例多房,其中2例为多房蜂窝状,9例为多房肥皂泡状。3例病灶为囊性,表现为低密度,其中2例可见壁结节,表现为软组织密度结节,3例病灶为实性,表现为软组织密度,10例病灶为囊实性,表现为等低密度,其中5例病灶行CT增强检查示实性部分明显强化。4例病灶囊壁连续,12例病灶囊壁不连续,但大部分病灶边界清楚并向唇、颊侧膨隆。大部分病灶邻近牙齿牙根呈截断状或锯齿状改变。8例下颌骨病灶累及下颌神经管导致下颌神经管显示不清。1例上颌骨病灶内含有1枚牙齿且病灶突入上颌窦腔。1例恶性造釉细胞瘤病灶周围出现软组织肿块,15例良性造釉细胞瘤病灶周围未见软组织肿块。结论颌骨造釉细胞瘤的病变部位、形态、内部结构及密度、邻近结构受累等具有一定特点,MSCT结合三维重组技术有助于该肿瘤的诊断及鉴别诊断。Objective To study the MSCT features of the jaw ameloblastoma, to review literature and improve the jaw ameloblastoma ability of diagnosis and differential diagnosis. Methods The MSCT features of 16 cases of jaw ameloblastomas were analyzed retrospectively, which were proved pathologically. The location and shape of lesions,inner and adjacent structure, the density of cystic contents on CT were analyzed combining 3D reconstruction. Results Among 16 cases, 13 lesions located in mandible, 3 lesions located in the upper jaw. Five lesions were unilocular, and2 of 5 lesions were lobulated, 11 lesions were multilocular, with honeycomb appearance in 2 and soap bubble in 9.Three lesions were cystic with low density. Three lesions were solid with soft tissue density. Ten lesions were cystic-solid with iso-low density compared with adjacent muscle and 5 of them with heterogeneous contrast enhancement of the solid component. Four lesions were of complete bony shell, and 12 lesions with partial bony shell, but the most of them were cystic expanding, root apex resorption generally demonstrated truncation or serration type in most of them.The mandibular canals were invaded by 8 lesions. The maxillary sinus was invaded by 1 lesion which was of one tooth in it. One malignant ameloblastoma resulted soft tissue mass, and benign ones usually did not. Conclusion There were some characteristic imaging findings of ameloblastomas in location, shape, inner structure, density, the ad-jacent structure invasion. MSCT combined 3D construction can be of great value in diagnosing and differential diag-nosing of ameloblastoma.

关 键 词：成釉细胞瘤 体层摄影术 螺旋计算机 诊断 

分 类 号：R739.8[医药卫生—肿瘤] R730.44[医药卫生—临床医学]