实性型牙源性角化囊肿的三维影像特点分析  

Three-dimensional radiographic features of solid variant of odontogenic keratocyst

作　　者：马化森 赵珺如 李玉冰 韩畅 宋阳婧 陈艳 孙志鹏 李刚[1] MA Huasen;ZHAO Junru;LI Yubing;HAN Chang;SONG Yangjing;CHEN Yan;SUN Zhipeng;LI Gang(Department of Oral and Maxillofacial Radiology,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology&NHC Research Center of Engineering and Technology for Computerized Dentistry&NMPA Key Laboratory for Dental Materials,Beijing,100081 China;Department of Oral Pathology,Peking University School and Hospital of Stomatology&National Center of Stomatology&National Clinical Research Center for Oral Diseases&National Engineering Research Center of Oral Biomaterials and Digital Medical Devices&Beijing Key Laboratory of Digital Stomatology&NHC Research Center of Engineering and Technology for Computerized Dentistry&NMPA Key Laboratory for Dental Materials,Beijing,100081 China)

机构地区：[1]国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京大学口腔医学院·口腔医院影像科,100081 [2]国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,口腔数字医学北京市重点实验室,国家卫生健康委员会口腔医学计算机应用工程技术研究中心,国家药品监督管理局口腔生物材料重点实验室,北京大学口腔医学院·口腔医院口腔病理科,100081

出　　处：《实用口腔医学杂志》2025年第2期168-172,共5页Journal of Practical Stomatology

基　　金：国家临床重点专科建设支持项目(编号:PKUSSNKP-202111)。

摘　　要：目的:利用多层螺旋CT(MSCT)分析颌骨实性型牙源性角化囊肿(SOKC)的三维影像学特征。方法:对8例颌面部实性型牙源性角化囊肿进行回顾性分析,结合临床、病理及MSCT表现,分析其三维影像学特点,包括病变位置、范围、边界、颌骨膨隆、房室分隔和周围结构受累情况。结果:8例患者(男4例、女4例),年龄37~65岁;发生在上颌骨和下颌骨各4例,均为单发病变;临床表现为颌骨病变区膨大,其中6例伴疼痛。螺旋CT显示,3例病变边界大致清晰,5例边界欠清晰,均有明显的颌骨膨隆;4例为多房透射性病变,4例为类似骨纤维病变的高低密度混杂性病变。上颌病变累及周围骨质较为明显,包括腭部、鼻腔、上颌窦及眶底;下颌病变均为复发性病变伴继发感染,可见周围软组织受累。结论:SOKC具有区别于普通牙源性角化囊肿的影像学特点,呈良性或低度恶性实性颌骨肿物表现。Objective:To analyze the three-dimensional radiographic characteristics of solid variant of odontogenic keratocyst(SOKC)using multi-slice spiral tomography(MSCT).Methods:Clinical records,histopathological reports and MSCT images of 8 patients were retrospectively acquired,radiographic features,including lesion site,size,borders,jaw expansion,internal structures and relationship with surrounding tissues were analyzed.Results:8 cases(4 males and 4 females)aged 37-65 years were included.Among them,4 lesions were located in the maxilla and the other 4 in mandible.Clinically,the lesions manifested as an enlargement of the affected area in the jaw bone,with pain present in 6 cases.On MSCT scans,all lesions showed evident jaw expansion.The boundaries of the lesions were clear in 3 cases,and unclear in 5 cases.4 cases exhibited multilocular radiolucent lesions,while the other 4 cases showed mixed radiolucent/opaque lesions resembling fibro-osseous lesion.The maxilla lesions involved the palate,nasal cavity,maxillary sinus and orbital floor.All mandible SOKCs were recurrent and infectious,with involvement of the surrounding soft tissue.Conclusion:SOKC exhibits imaging characteristics that differentiate from conventional odontogenic keratocysts.Radiographically,it presents as a benign or low-grade malignant solid jaw mass.

关 键 词：实性型牙源性角化囊肿 螺旋CT 影像诊断 

分 类 号：R739.8[医药卫生—肿瘤] TP391.73[医药卫生—临床医学]