髁突骨软骨瘤的CT与MRI诊断价值比较  

Comparision of computed tomography and magnetic resonance imaging for the diagnosis of condylar osteochondroma

作　　者：沈末伦[1] 朱凌[2] 王旭东[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院.口腔医学院口腔颅颌面科上海市口腔医学重点实验室,上海200011 [2]上海交通大学医学院附属第九人民医院放射科,上海200011

出　　处：《中国口腔颌面外科杂志》2017年第2期147-152,共6页China Journal of Oral and Maxillofacial Surgery

基　　金：上海市市级医院新兴前沿技术联合攻关项目(SHDC12013103);上海交通大学医学院"高峰高原"计划"研究型医师"项目(20152225)

摘　　要：目的 :比较CT和MRI在髁突骨软骨瘤诊断中的价值。方法 :回顾分析29例髁突骨软骨瘤患者的CT和MRI表现,观察肿瘤形态、部位、与髁突的连续性、软骨帽、软骨膜结构以及髁突、颞骨关节面、颞下颌关节盘、关节腔、翼外肌等软、硬组织改变情况。采用SPSS17.0软件包对数据进行统计学分析。结果:CT和MRI均可显示髁突骨软骨瘤骨皮质和骨松质与髁突的连续性。MRI对软骨帽和软骨膜的检出率均显著高于CT(P<0.05)。CT和MRI的诊断准确率分别为72.4%和75.9%,差异无显著性(P>0.05)。CT和MRI对颞骨关节面改建(9例)、髁突脱位(9例)及假关节形成(11例)的检出率相同。MRI显示2例患侧和7例对侧颞下颌关节盘移位以及18例患侧和12例对侧关节腔积液,而CT无法显示关节盘移位和关节腔积液情况。MRI对翼外肌萎缩伴脂肪变性的检出率高于CT,但差异无统计学意义(P>0.05)。结论:CT和MRI均可清晰显示髁突骨软骨瘤骨皮质和骨松质与髁突的连续性特征以及毗邻硬组织改变情况,两者诊断准确率相当,但MRI在显示肿瘤的软骨帽和软骨膜结构以及颞下颌关节和毗邻软组织改变方面优于CT。PURPOSE： To compare the value of computed tomography （CT） and magnetic resonance imaging （MRI） for diagnosis of condylar osteochondroma. METHODS： The imaging manifestations of CT and MRI were retrospectively analyzed in 29 patients with condylar osteochondroma. The shape, position, continuity with condylar process, cartilage cap, perichondrium structure of the tumors as well as the changes of the soft and hard tissues adjacent to the lesions including the mandibular condyle, temporal bone joint surface, articular disc of temporomandibular joint （TMJ）, articular cavity and lateral pterygoid muscle were evaluated. SPSS17.0 software package was used to analyze the data. RESULTS： The continuity of the tumor bone cortex and marrow with that of the underlying condyle could be observed with both CT and MRI. The detection rates for cartilage cap and perichondrium with MRI were significantly higher than with CT （P〈0.05）. The diagnostic accuracy of CT and MRI was 72.4% and 75.9%, respectively, but there was no significant difference （P〉 0.05）. The detection rates for temporal bone joint surface reconstruction （9 cases）, condylar dislocation （9 cases） and pseudarthrosis formation （11 cases） with CT were identical to those with MRI. MRI showed ipsilateral articular disc displacement in 2 cases and eontralateral in 7 cases, ipsilateral articular cavity effusion in 18 cases and contralateral in 12 cases. But CT couldn＇t show articular disc displacement and articular cavity effusion. The detection rate for atrophy and fatty degeneration of the lateral pterygoid muscle with MRI was higher than with CT, but the difference was not statistically significant （P〉0.05）. CONCLUSION： Both CT and MRI could clearly show the characteristic continuity of condylar osteochondroma bone cortex and marrow with that of the underlying condyle as well as the changes of the hard tissues adjacent to the lesion. They had an identical diagnostic accuracy, but the value of MRI to reveal tumor cartilage

关 键 词：髁突 骨软骨瘤 计算机断层扫描 磁共振成像 

分 类 号：R739.8[医药卫生—肿瘤]