胫骨骨性纤维结构不良的影像学表现与临床病理分析  

Imaging findings of osteofibrous dysplasia in tibia and its clinicopathological analysis

作　　者：陈博[1] 戴婷婷[1] 程建敏[1] 蒋乐真 陈旺强[1] 陈铨栩 林立本 

机构地区：[1]温州医科大学附属第二医院育英儿童医院放射科,浙江温州325027 [2]温州医科大学附属第二医院育英儿童医院病理科,浙江温州325027

出　　处：《实用放射学杂志》2018年第2期260-262,共3页Journal of Practical Radiology

摘　　要：目的 探讨胫骨骨性纤维结构不良（OFD）的影像表现及临床病理特点。方法 回顾性分析10例经病理证实、临床资料完整的胫骨OFD的影像学表现。结果 本病好发于儿童，临床主要表现为小腿前部包块和前弓畸形。X线及CT检查示病变沿胫骨长轴分布，9例累及前侧骨皮质，另1例累及后侧骨皮质；7例累及胫骨中段，另3例位于胫骨中上1/3交界区；9例呈膨胀性多房样溶骨性破坏，表现为多个低密度病灶之间有厚度不等的高密度骨性间隔，另1例呈单房样溶骨性破坏，灶周见硬化带。3例MRI检查T2WI病灶均表现为多泡状等/高信号灶及带状低信号间隔。镜检示病变由纤维组织和骨小梁构成，纤维组织疏密不等，骨小梁周围有较多骨母细胞围绕及数量不等的破骨细胞。病变呈带状分布，中央带纤维较多，骨小梁较少（对应于影像的溶骨性破坏区），周边带骨小梁逐渐增多，形成丰富的互相吻合的板层骨（对应于影像的骨性间隔）。结论 胫骨OFD以前侧骨皮质内多个低密度病灶（T2WI呈多泡状等/高信号灶）之间有厚度不等的高密度骨性间隔（T2WI呈带状低信号间隔）为特征，反映了其病理改变，综合各种影像表现并结合临床特点，典型病例可作出诊断。Objective To investigate the imaging findings and clinicopathological features of osteofibrous dysplasia（OFD） in tibia.Methods The imaging findings of 10 cases with OFD in tibia, which were confirmed by pathology and had complete clinical data were analyzed retrospectively.Results The disease occurred in children and the main clinical manifestations were anterior mass and arch deformity of calf.X-ray and CT examinations showed that the lesion distributed along the long axis of tibia and the anterior cortex was involved in 9 cases and the posterior cortex was involved in another one;the midpieee of tibia was involved in 7 cases and the lesion located at the junction area between upper third and middle third of tibia in another 3 cases; 9 cases showed multilocular osteolytic lesions within the expanded cortex, manifesting as the high-density bony intervals of different thickness among a number of low-density lesions and another one presented as unilocular osteolytic lesion with sclerosis rim. Lesions manifested as multiple bubble-like intermediate or high signal intensity foci and low-signal interval bands on T2 WI in 3 cases of MRI examinations. Microscopic examinations revealed that the lesion was composed of fibrous tissue and trabecular bone, fibrous tissue varied from sparse to dense and trabecular bone was surrounded by a great many osteoblasts and osteoclasts of vary number.The lesion presented as band-shaped distribution with more fibrous tissue and less trabecular bone in the central zones （corresponding to osteolytic destruction areas in radiography） and with trabecular bone gradually increasing in the peripheral zones to form abundant merged lamellar bone （corresponding to bony intervals in radiography）.Conclusion OFD in tibia is characterized by the high-density bony intervals（ low-signal interval bands on T2WI） of different thickness among a number of low-density lesions（multiple bubble-like intermediate or high signal intensity foci on T2 WI） within anterior cortex, which reflects

关 键 词：胫骨 骨性纤维结构不良 计算机体层成像 磁共振成像 病理学 

分 类 号：R681[医药卫生—骨科学] R814.42[医药卫生—外科学]