上颌成釉细胞瘤、牙源性角化囊肿及含牙囊肿的螺旋CT和锥形束CT影像分析  

Imaging analysis of ameloblastoma, odontogenic keratocyst and dentigerous cyst in the maxilla using spiral CT and cone beam CT

作　　者：孟圆[1] 张亚琼 叶欣 赵雅宁 陈艳[2] 柳登高[1] Meng Yuan;Zhang Yaqiong;Ye Xin;Zhao Yaning;Chen Yah;Liu Denggao(Department of Oral and Maxillofacial Radiology,Peking University School and Hospital of Stomatology ＆ National Clinical Research Center for Oral Diseases ＆ National Engineering Laboratory for Digital and Material Technology of Stomatology ＆ Beijing Key Laboratory of Digital Stomatology,Beijing 100081,China;Department of Oral Pathology,Peking University School and Hospital of Stomatology ＆ National Clinical Research Center for Oral Diseases ＆ National Engineering Laboratory for Digital and Material Technology of Stomatology ＆ Belting Key Laboratory of Digital Stomatology,Beijing 100081,China)

机构地区：[1]北京大学口腔医学院·口腔医院医学影像科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,100081 [2]北京大学口腔医学院·口腔医院病理科,100081

出　　处：《中华口腔医学杂志》2018年第10期659-664,共6页Chinese Journal of Stomatology

摘　　要：目的 利用螺旋CT和锥形束CT分析上颌骨成釉细胞瘤（ameloblastoma,AM）、牙源性角化囊肿（odontogenic keratocyst,OKC）及含牙囊肿的影像学特点,以期为临床提供参考.方法 收集2012年12月至2017年5月于北京大学口腔医学院·口腔医院医学影像科就诊的有完整临床资料、病理诊断及螺旋CT或锥形束CT影像的上颌骨原发性AM、OKC与含牙囊肿患者85例,分析病变的影像学特点,包括形态、膨隆情况、内部结构及与周围组织的关系等.结果 共纳入85例患者,男性56例,女性29例,年龄8～84岁.22例AM中11例为促结缔组织增生型,16例横断面为类圆形,18例唇颊侧骨质膨隆.44例OKC中l例为双侧上颌病变,共计45侧病变,26侧为类圆形;30侧唇颊侧膨隆;22侧充满上颌窦;26侧含牙,包括向心型11侧、偏心型4侧及贴壁型11侧.19例含牙囊肿中l例为双侧病变,共计20侧病变,均为单房;包括向心型8侧,偏心型6侧及贴壁型6侧;16侧病变有唇颊侧膨隆.结论 本组病例中上颌AM促结缔组织增生型较多,多为类圆形,唇颊侧膨隆多见;上颌OKC形态呈多样性,易突人上颌窦,可为含牙病变;含牙囊肿和OKC的囊肿与所含牙的关系可为向心型、偏心型及贴壁型.Objective To analyze the radiolographic features of ameloblastoma （AM）,odontogenic keratocyst （OKC） and dentigerous cyst （DC） in the maxilla by spiral CT （SCT） and cone-beam CT （CBCT）,and to provide useful information for the differential diagnosis of benign radiolucent lesions in the maxilla.Methods Clinical records,histopathological reports and SCT or CBCT imaging of 85 patients with primary maxillary AM,OKC or DC admitted to Peking University School and Hospital of Stomatology from December 2012 to May 2017 were collected.Radiographic characteristics including site,size,shape,cortex expansion,internal structure and effects on neighboring tissue were analyzed.For OKC and DC,the relationship between cysts and enveloped teeth was classified as centripetal,eccentric and adherent.Results The 85 patients included 56 males and 29 females,aged from 8 to 84 years old.Eighty-three patients had a single lesion,whereas 2 patients had bilateral cysts.In total,87 lesions were analyzed,comprising 22 AM,45 OKC and 20 DC.Among the 22 AM,11 lesions were desmoplastic type,16 were round-like in shape and 18 presented with buccal expansion.The shapes of the 450KC varied as round-like （n=26）,oval （n=3）,reniform （n=4）,sinus-like （n=5）,sinus ＋ round （n=5） and irregular （n=2）.Furthermore,30 OKC presented with buccal expansion,22 nearly filled the maxillary sinus and 26 were＇dentigerous＇.The tooth-cyst relationship of the＇dentigerous＇ OKC was centripetal in 11,eccentric in 4 and adherent in 11.Among the 20 unicystic DC,8 lesions were centripetal,6 were eccentric and 6 were adherent type;16 DC presented with buccal expansion.Conclusions Demosplastic type is common in maxillary AM.Most AM are round-like in shape and expand buccally.The shape of maxillary OKC varies greatly and maxillary sinus filling is common.More than a half of OKC appear＇dentigerous＇.For DC and OKC,tooth-cyst relationship can be centripetal,eccentric and adherent.

关 键 词：成釉细胞瘤 含牙囊肿 牙源性角化囊肿 体层摄影术 螺旋计算机 

分 类 号：R739.8[医药卫生—肿瘤] R782.1[医药卫生—临床医学]