短骨骨样骨瘤的影像诊断  

Imaging diagnosis of osteoid osteoma of short bone

作　　者：张福全 林明强 李方元 侯雪霖 李晓莉 孙博 ZHANG Fuquan;LIN Mingqiang;LI Fangyuan;HOU Xuelin;LI Xiaoli;SUN Bo(Medical imaging Department,The Second People's Hospital of Laizhou,Yantai 261423,China;Department of Radiology,Shandong Wendeng Orthopedic Hospital,Weihai 264400,China;Medical imaging center,Jinan Nanjiao Hospital,Jinan 250002,China;Department of Imaging,Affiliated Hospital of Heze Medical College,Heze 274046,China;Department of Pathology,Affiliated Hospital of Heze Medical College,Heze 274046,China;Department of Medical Imaging,Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东省莱州市第二人民医院医学影像科,山东烟台261423 [2]山东省文登整骨医院放射科,山东威海264400 [3]济南南郊医院医学影像中心,山东济南250002 [4]菏泽医学专科学校附属医院影像科,山东菏泽274046 [5]菏泽医学专科学校附属医院病理科,山东菏泽274046 [6]山东第一医科大学附属省立医院医学影像科,山东济南250021

出　　处：《医学影像学杂志》2023年第11期2074-2076,2081,共4页Journal of Medical Imaging

摘　　要：目的探讨短骨骨样骨瘤的影像学特征,旨在减少该病的漏诊和误诊。方法选取9例短骨骨样骨瘤的影像学资料,所有病例均经手术病理证实。其中7例行X线摄影(DR)检查,1例行数字化体层摄影检查,7例行CT检查,4例行MRI检查。结果9例短骨骨样骨瘤的瘤巢直径3~9 mm,周围软组织可见明显梭形肿胀。DR和CT检查表现为类圆形低密度瘤巢,周围可见骨质硬化和骨皮质增厚。瘤巢内可出现高密度钙化或骨化,与周围的骨质硬化区间隔以环形透亮区,为本病的特征性表现。压脂T_(2)WI序列可清楚显示瘤巢周围软组织及骨髓水肿。结论短骨骨样骨瘤较为少见,且临床和影像学表现软组织肿胀,因而影像诊断常较为困难,准确识别瘤巢是诊断短骨骨样骨瘤的关键。Objective To explore the imaging features of osteoid osteoma of short bone in order to reduce the missed diagnosis and misdiagnosis of the disease.Methods We retrospectively analyzed the images of 9 cases of osteoid osteoma in short bone,which were confirmed by surgery.Seven cases underwent X-ray plain film photography,1 case underwent Digital Tomography scan,7 cases underwent CT and 4 cases underwent MRI scan.Results The nest diameter of osteoid osteoma of short bone was 3~9 mm.Obvious spindle swelling was found in surrounding soft tissue.X-ray and CT showed round-like low-density tumor nests with surrounding bone sclerosis and cortical thickening.High density calcification or ossification may occur in the tumor nest,and a circular transparent area was separated from the surrounding sclerotic area,which was the characteristic manifestation of the disease.The fat-pressed T_(2)WI sequence could clearly show the edema of soft tissue and bone marrow around the tumor nests.Conclusion Osteoid osteoma of short bone is rare,and its clinical and imaging manifestations are often atypical,so imaging diagnosis is difficult.Accurate recognition of tumor nests is the key to the diagnosis of osteoid osteoma.

关 键 词：骨样骨瘤 短骨 体层摄影术 X线计算机 磁共振成像 

分 类 号：R683.42[医药卫生—骨科学] R445.2[医药卫生—外科学]