高频超声检查对颌骨病变诊断价值的分析  

Preliminary analysis of the diagnostic value of high-frequency ultrasound in jaw lesions

作　　者：张芹 许华宁 武和明[2] 吴意赟 高慧 宋旭光 ZHANG Qin;XU Huaning;WU Heming;WU Yiyun;GAO Hui;SONG Xuguang(Department of Ultrasound,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China;Department of Maxillofacial Surgery,Stomatological College of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京中医药大学附属医院超声医学科,江苏南京210029 [2]南京医科大学附属口腔医院颌面外科,江苏南京210000

出　　处：《医学影像学杂志》2025年第1期28-31,共4页Journal of Medical Imaging

基　　金：江苏省中医药科技发展计划项目(编号:MS2022021)。

摘　　要：目的探讨高频超声检查对颌骨肿瘤及肿瘤样病变的诊断价值。方法选取经手术病理证实的43例颌骨病变(JL)患者的超声检查结果,分析其声像图表现,总结颌骨肿瘤及肿瘤样病变不同病理类型的超声检查表现。结果43例患者包括颌骨囊肿22例(51.16%,22/43),其中牙源性角化囊肿11例,其他牙源性颌骨囊肿11例;颌骨良性肿瘤及肿瘤样病变16例(37.21%,16/43),其中造釉细胞瘤7例、牙源性黏液瘤1例、骨化性纤维瘤2例、颌骨脉管畸形2例、骨纤维异常增殖3例、朗格汉斯细胞增生症1例;颌骨恶性肿瘤5例(11.63%,5/43),其中浆细胞性骨髓瘤1例、黏液表皮样癌1例、骨肉瘤1例、鳞状细胞癌1例、炎性肌纤维母细胞瘤1例。超声检查对颌骨恶性病灶的诊断敏感度、特异度分别为80.00%、97.37%,病灶良恶性诊断准确率为95.35%。颌骨囊肿超声检查特点:病灶内呈无回声区,透声好或差,彩色多普勒超声检查显示病灶内未见明显血流信号,符合率90.91%;颌骨良性肿瘤颌骨多膨胀改变,病灶内低回声或无回声,彩色多普勒超声检查显示病灶实性部分探及Ⅰ~Ⅲ级血流不等,符合率81.25%;恶性病灶颌骨皮质不连续,呈虫蚀样,周围伴形态不规则的软组织肿块,肿块血流丰富,符合率80.00%。结论超声检查能明确颌骨肿瘤及肿瘤样病变的囊实性,鉴别颌骨病灶的良恶性,为颌骨病灶诊断提供新方法,为临床治疗方案的选择提供可靠依据。Objective To evaluate the value of high frequency ultrasound in the diagnosis of jaw tumors and tumor-like lesions.Methods The ultrasonic results of 43 patients with jaw lesions confirmed by surgical pathology were collected.The ultrasonic characteristics of different pathological types were summarized.Results All 43 patients in this study included 22 cases of jaw cysts,i.e.,11 cases of odontogenic keratogenic cysts and 11 cases of odontogenic jaw cysts.There were16 cases of benign tumors and tumor-like lesions,of which 7 cases were ameloblastomas.The others included odontogenic myxoma(n=1),ossifying fibroma(n=2),vascular malformation of jaw(n=2),fibrous dysplasia of bone(n=3)and Langerhans cell hyperplasia(n=1).5 cases of jaw malignant tumors included plasmacytoid myeloma(n=1),mucoepidermoid carcinoma(n=1),osteosarcoma(n=1),squamous-cell carcinoma(n=1),and inflammatory myofibroblastoma(n=1).The sensitivity and specificity of ultra⁃sound in the diagnosis of malignant lesions were 80.00%and 97.37%,respectively.The accuracy was 95.35%.The ultrasonographic features of jaw cyst were as follows:no echo area in the lesion,good or bad sound transmission,no obvious blood flow signal in the lesion by color Doppler,and with the coincidence rate of 90.91%.There were low or no echo in the benign lesions,the blood flow of the solid part of the lesion was different from Grade Ⅰ to Ⅲ detected by color Doppler,the coincidence rate was 81.25%,the cortex of the malignant lesion was discontinuous and wormlike,the surrounding soft tissue mass with irregular shape had abundant blood flow,and the coincidence rate was 80.00%.Conclusions Ultrasound can identify the cystic and solid nature of jaw tumors and tumor-like lesions,differentiate the benign and malignant lesions,and provide a new method for the diagnosis of jaw lesions and a reliable basis for the selection of clinical treatment.

关 键 词：颌骨病变 超声检查 

分 类 号：R739.82[医药卫生—肿瘤] R445.1[医药卫生—临床医学]