软骨母细胞瘤和原发性动脉瘤样骨囊肿CT三维重建对比分析  

Comparative analysis of CT 3D reconstruction of chondroblastoma and primary aneurysmal bone cyst

作　　者：胡浩 周利华 吕国义[1] Hu Hao;Zhou Lihua;Lv Guoyi(Department of Radiology,Wuhan Fourth Hospital,Wuhan 430033,Hubei Province,China)

机构地区：[1]武汉市第四医院(武汉市骨科医院)放射科,武汉430033

出　　处：《中国临床解剖学杂志》2024年第3期326-330,共5页Chinese Journal of Clinical Anatomy

摘　　要：目的 探讨软骨母细胞瘤(chondroblastoma,CB)与原发性动脉瘤样骨囊肿(aneurysmal bone cyst,ABC)的三维CT影像表现及鉴别点。方法 回顾性分析经手术、病理及免疫组织化学证实的单纯CB(22例)、CB伴ABC(5例)和原发性ABC(24例)患者的三维CT和临床资料。结果 三组病变三维CT均表现为单发、边界清晰的溶骨性骨质破坏。CB组、CB伴ABC组病灶最大径均小于ABC组(P<0.05)。CB组位于不规则骨(54.5%)、偏心性(86.4%)、钙化(50%)、邻关节面(77.3%)及突破骨皮质(54.5%)发生率高于ABC组(分别为20.8%、29.2%、8.3%、4.2%及25.0%),P<0.05,膨胀性生长(40.9%)和合并病理性骨折(18.2%)发生率低于ABC组(75.0%、45.8%),P<0.05;CB组与ABC组分叶征、边缘硬化、骨嵴和累及骨皮质征象发生率不存在统计学差异(P>0.05)。结论 病变的解剖部位和CT三维征象对CB和ABC的鉴别诊断有重要价值。Objective To investigate the three-dimensional CT features and differential points of chondroblastoma(CB) and primary aneurysmal bone cyst(ABC).Methods The three-dimensional CT findings and clinical data of 22 patients of simple CB,5 patients of CB secondary aneurysmal bone cyst and24 patients of primary ABC confirmed by surgical pathology and immunohistochemistry were retrospectively analyzed.Results The three groups showed single osteolytic bone destruction with clear boundary on three-dimensional CT.The maximum diameters of lesions in CB group and CB secondary aneurysmal bone cyst group were smaller than that in ABC group(P<0.05).The incidences(54.5%,86.4%,50%,77.3%,54.5%)of irregular bone,eccentricity,calcification,adjacent articular surface,and penetration of cortical bone in CB group were higher than those in ABC group(20.8%,29.2%,8.3%,4.2%,25.0%)(P<0.05),and the incidences(40.9%,18.2%) of expansion growth and pathological fracture were lower than those of ABC group(75.0%,45.8%)(P<0.05).However,there was no significant difference in the incidence of sign of lobulation,marginal sclerosis,bone crest and cortical involvement between CB group and ABC group(P>0.05).Conclusions The anatomical location of the lesions and the CT three-dimensional signs are of great value in the differential diagnosis of CB and ABC.

关 键 词：软骨母细胞瘤 动脉瘤样骨囊肿 鉴别诊断 计算机断层成像 

分 类 号：R738[医药卫生—肿瘤]