颌骨静脉畸形的CT表现特征及与颌骨骨肉瘤的鉴别诊断  

CT features of jaw venous malformations and differential diagnosis from osteosarcoma of the j aw

作　　者：王晶波 陶晓峰[1] 朱凌[1] WANG Jingbo;TAO Xiaofeng;ZHU Ling(Department of Radiology,Shanghai Ninth People's Hospital,Shanghai JiaotongUniversity School of Medicine,Shanghai 200011,China)

机构地区：[1]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：《实用放射学杂志》2019年第6期880-883,926,共5页Journal of Practical Radiology

摘　　要：目的分析颌骨静脉畸形(VM)的CT特征,评价CT鉴别颌骨VM与骨肉瘤的效果及诊断意义.方法回顾分析病理确诊的颌骨VM22例及颌骨骨肉瘤13例,行CT平扫和(或)增强检查.对比病灶位置、形态、与周围组织关系以及CT值特点,行统计学分析。结果50%的颌骨VM见扇形骨小梁,31.8%见蚓状血管,无侵袭性骨膜反应;53.8%骨肉瘤见侵袭性骨膜反应,无扇形骨小梁及蚓状血管,有统计学差异(P<0.01)。增强最小CT值及平扫最大CT值对鉴别颌骨VM及骨肉瘤有意义(P<0.05,U>0)。此2项CT值及其联合参数AUC分别为0.735、0.864及0.956。结论病变区扇形骨小梁及蚓状血管可提示诊断。颌骨VM平扫最小CT值较低,增强最小CT值较高。平扫最大CT值及增强最小CT值联合参数对颌骨VM及骨肉瘤的鉴别诊断效果较好。Objective To analyze the CT imaging features of jaw venous malformation (VM),and to evaluate the effect and diagnostic significance of CT in differentiating VM from osteosarcoma of the j aw.Methods 22 cases with pathological diagnosis of j aw VM and 13 cases of jaw osteosarcoma were reviewed on their CT images’morphologic characters and CT values.SPSS statistics 25.0 software package was used for statistical analysis.Results 50% of jaw VM cases showed fanGshaped bone trabecula structure,and 31.8% showed lumbricoid vessels.No invasive periosteal reaction was found in jaw VM cases.53.5% of jaw osteosarcoma cases showed invasive periosteal reactions.Neither fanGshaped bone trabecula structure nor lumbricoid vessels was found in jaw osteosarcoma cases.Significantly statistical differences existed in these morphologic characters between these two groups (P<0.01).Minimum enhanced CT value and maximum nonGenhanced CT value were statistically different between the two groups (P<0.05 ,U> 0).The AUC of minimum enhanced CT value,maximum plain CT value,and the combined predict parameter of these two values were 0.735,0.864,and 0.956,respectively.Conclusion FanGshaped bone trabecula structure and lumbricoid vessels are key features in diagnosing jaw VM on CT.Jaw VM has a lower maximum nonGenhanced CT value and a higher minimum enhanced CT value than jaw osteosarcoma has.The combined predict parameter of these two values has good diagnostic efficacy.

关 键 词：静脉畸形 骨肉瘤 颌骨 计算机体层成像 

分 类 号：R543.6[医药卫生—心血管疾病] R739.91[医药卫生—内科学]