成人骨性纤维结构不良的影像学与病理表现(附3例分析)  

Imaging and pathological findings of adult osteofibrous dysplasia(analysis of 3 cases)

作　　者：葛英霖[1] 肖纪涛 李孟磊 侯广武[1] GE Yinglin;XIAO Jitao;LI Menglei;HOU Guangwu(Department of Radiology,the Second People’s Hospital of Liaocheng of Shandong Province,Liaocheng 252600,P.R.China)

机构地区：[1]山东省聊城市第二人民医院放射科,山东聊城252600

出　　处：《医学影像学杂志》2020年第6期1076-1078,1083,共4页Journal of Medical Imaging

摘　　要：目的探讨成人骨性纤维结构不良(OFD)的影像学表现。方法收集3例经病理证实的成人OFD资料,回顾性分析其X线摄影、CT及磁共振表现。结果本组3例5个病灶成人OFD均无小腿前弓畸形,2例表现为小腿前部隆起,1例被偶然发现。影像学检查显示病变位于胫骨骨干,沿骨长轴分布;所有病灶位于皮质内或皮质下,3病灶累及前侧骨皮质,2病灶累及侧方骨皮质;所有病灶均呈偏心溶骨性破坏,边缘清晰硬化;4病灶呈膨胀性生长,3病灶内见骨嵴。磁共振检查2例,STIR序列像显示3病灶内可见条带状低信号。镜检见病变由纤维成分和编织骨小梁构成,纤维细胞形态温和,骨小梁周围有骨母细胞围绕,总体呈带状分布模式。结论成人OFD虽罕见,但具有一定特点,结合其特征性发病部位可作出诊断。Objective To investigate the imaging findings of adult osteofibrous dysplasia(OFD).Methods Three cases of adult OFD confirmed by pathology were collected and their X-ray,CT and magnetic resonance appearances were analyzed retrospectively.Results There was no the anterior bowing deformity of calf in all the patients.Two cases presented with anterior crural mass and one case was found by accident.Imaging examination showed that the lesions were located in the tibial shaft and distributed along the long axis of the bone;all lesions were located in cortex or subcortex of tibia,in which 3 lesions involved anterior cortex,2 lesions involved lateral cortex;all lesions showed eccentric osteolytic destruction with clear and sclerotic margins;4 lesions were expanded,and bony crest was seen in 3 lesions.2 cases underwent MR examination,and banded hypointense was seen in 3 lesions on STIR sequence.Microscopically,the lesions were composed of fibrous components and woven bone trabeculae.Fibroblastic cells were bland,and bone trabeculae was surrounded by osteoblasts.Generally,the lesions demonstrated zonal distribution pattern.Conclusion Although adult OFD is rare,it has some characteristics and can be diagnosed in combination with its characteristic location.

关 键 词：成年人 骨性纤维结构不良 X线摄影 体层摄影术 X线计算机 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]