累及颅骨病变的CT诊断与鉴别诊断  

Skull Involved by Pathological Changes:CT Diagnosis and Differential Diagnosis

作　　者：刘晓虹[1] 许永华[1] 耿道颖[2] 姚振威[2] 张晓龙[2] 

机构地区：[1]上海市第八人民医院放射科,200233 [2]复旦大学附属华山医院放射科

出　　处：《中国医学计算机成像杂志》2003年第4期248-252,共5页Chinese Computed Medical Imaging

摘　　要：目的 :分析累及颅骨不同病变的CT表现特征 ,探讨CT诊断此类病变的诊断价值。材料和方法 :收集了72例累及颅骨病变的CT扫描表现 ,参照手术、病理资料 ,加以分析。CT检查采用美国GE公司Hispeed全身扫描机 ,全部病例作CT平扫和增强扫描。结果 :72例患者 ,年龄19～72岁 ,平均45岁 ,女性38例 ,男性33例。颅骨纤维异常增殖症1例 ,骨化性纤维瘤1例 ,脊索瘤6例 ,软骨瘤1例 ,颅咽管瘤6例 ,垂体瘤19例 ,听神经瘤13例 ,脑膜瘤22例 ,颅骨血管瘤2例,转移性颅骨肿瘤1例。累及颅骨的病变虽然复杂多变 ,但有4种形式颅骨受累的CT表现有一定的特征性 :骨质压迫吸收、变薄 ,骨质反应性增生、硬化 ,骨质破坏、吸收 ,颅底孔道的改变。此外 ,病变的病理起源与好发部位有密切的关联。结论 :CT显示骨质细微改变的优势结合轴。Purpose:To analyses the CT feature of skull involved by various kinds of pathological changes and to investigate the value of CT in diagnosis.Materials and Methods:CT data of72cases involved with pathological changes of skull were selected.Detailed analysis of CT features was conducted with the consideration of both surgical and pathologic results.Pre-and post-enhancement CT scan were conˉducted on American GE Hispeed CT system in all cases.Results:Among the72cases,patients ranged from19to72years old with average of45,38were female and33were male.There are osteofibrodysˉplasia(n=1),osteofibroma(n=1),chordomas(n=6),chondroma(n=1),craniopharyngiomas(n=6),pituitary macroadenomas(n=19),acoustic tumours(n=13),meningiomas(n=22),skull angioma(n=2)and metastasis(n=1).Despite the complication of various pathological changes of skull,there are four major characteristics in term of CT features:skull being absorpted and getting thin;skull hyperplasia and stiffness;skull destruction and absorption;base of skull duct changing.In addition,pathological changes were related to the pathology origin and areas where diseases easily took place.Conclusion:CT plays a significant role in detecting even minor bone structure changes.It is important to combine thin slice thickness CT scan with axial and coronal position in order to make accurate diagnosis and differential diˉagnosis.

关 键 词：颅骨病变 CT表现 鉴别诊断 骨质破坏 原发病 

分 类 号：R816.8[医药卫生—放射医学]