非骨化性纤维瘤临床X线诊断.DOCVIP

临床医学论文-非骨化性纤维瘤临床X线诊断 【关键词】? 非骨 【摘要】 目的 探讨非骨化性纤维瘤的临床及X线表现以提高诊断水平。方法 所有病例均摄有X线平片，分析经病理证实的12例非骨化性纤维瘤。结果 临床症状轻，好发于下肢长骨干骺端或骨干，股骨6例，胫骨4例，下颌骨及肋骨各1例;皮质型10例表现为皮质内或紧贴皮质下的单层或多层透亮区，病变向骨内发展进入髓腔，周围有致密硬化带环绕，以髓腔侧明显;髓质型2例，病灶在骨内中央发展，显示为单房或多房透亮区，边缘有硬化，骨皮质菲薄，轻微向周围膨隆。结论 X线为最基本检查方法，典型病例X线平片结合临床症状即可明确诊断。 关键词 非骨化性纤维瘤 X线 诊断 【Abstract】 Objective To improve the diagnosis of non-ossifying fiboma by analysing its clinical and X-ray，feature. Methods Plain X-ray films was performed in all patients. X-ray finding in12cases with pathologically-confirmed non-ossifying were analyzed. Results The clinical symptom was mild，the lesions occurred usually at the metaphysis of the long bones，The affected bones included femur（n=6），tibia（n=4）ribs（n=1）lowerjaw（n=1）.Cortical type was seen in10cases，presenting as unilocular or multilacular，transparent areas with in the cortex or tightly beneath the cortex，the lesion had a sclerotic margin. Which was more obvious at the marrow side. Medullary type was seen in 2 cases.The Lesion was located at the center of the bone and grew centrally. The tumor was manifested as unilocular or multilocular. Tramsparent area with sclerotic border and the bone cortex became thinner with slightly expanding on11sides. Conclusion Plain radiography is the elementaly means to detect this disease. Based on the typical X-ray signs of non-ossifying fibroma combined with clinical data，correct preoperative diagnosis can be made in most cases. Key words non-ossifying fibroma X-ray diagnosis? 骨的非骨化性纤维瘤是一种比较少见的原发性良性肿瘤，国内多为零星报道，笔者收集我院自1984～2004年近20年来经病理手术证实的非骨化性纤维瘤（non-ossifying Fibroma，NoF）进行回顾性分析。以提高对NoF的认识和诊断水平。 1 临床资料 本组12例，男8例，女6例，年龄5～48岁，其中青少年10例，占83.3%，10岁以下3例，10～20岁6例，20～30岁1例，30岁以上2例，全部病例均经手术病理证实。2例因外伤而首次就诊，1例因下颌肿物而就诊，全部病例临床症状轻微，实验室检查无明显异常发现，所有病例均摄有X线侧位平片。 2 结果 本组12例病灶全部为单发，其中股骨6例，胫骨4例，下颌骨1例，肋骨1例。（1）发生于长骨皮质内或紧贴皮质下，X线平片表现为干骺区或骨干大小不等的单房或多房偏心性膨胀性透亮区，单房8例，多房2例，病灶内可见纤细而不规则的骨性间隔或骨嵴，发生于皮质内向外膨降且皮质菲薄8例，邻近骨皮质内缘向髓腔生长2例，8例瘤周有厚薄不均的硬化带，部分边缘呈波浪状，2例合并病理骨折，周围有软组织肿胀，其中1例见少量骨膜反应性增生;（2）2例骨髓腔内多房膨胀性透亮区，病变沿患骨