动脉瘤样骨囊肿的影像学诊断_临床医学论文.docVIP

动脉瘤样骨囊肿的影像学诊断_临床医学论文 动脉瘤样骨囊肿的影像学诊断_临床医学论文 【摘要】 目的 分析、探讨动脉瘤样骨囊肿（Anuerysmal Bone Cyst，ABC）的影像学特征及不同影像学检查方法的诊断价值，提高ABC术前诊断正确率。 方法 回顾性分析11例经病理证实且资料完整的ABC病人并结合文献资料，分析ABC的各种影象学表现及其病理基础，总结ABC较特征性的影像学征象。 结果 病变表现为囊状膨胀性骨质破坏10例，平片显示膨胀骨皮质呈线形包壳者4例，CT显示囊内纤维性或骨性间隔4例，密度不均呈多囊状，病变大部为液性低密度区3例，MR T2WI显示病变内部信号极不均匀呈海绵状液性信号4例。 结论 ABC有较特征性的影像学表现，平片、CT、MRI可从不同方面反映ABC的影像学特征，三者结合可提高ABC的术前诊断正确率。 【关键词】 动脉瘤样骨囊肿; 影像学 诊断 [Abstract] Objective To investigate the image features of anuerysmal bone cyst (ABC), and to evaluate the value of various imaging methods in the diagnosis of ABC, and to improve the accuracy rate of preoperative diagnosis of ABCs. Methods Eleven patients with ABCs confirmed by pathology and full clinical data were studied retrospectively. The various image and pathologic manifestations were studied carefully in order to find the imaging characteristics of ABCs. Results Cystic expansive destruction of bone were found in 10 patients. On CT images, the fibrous or osseous septa were showed in the lesion in 4 patients, mainly low density area in the lesion in 3 patients. On MR images, the T2WI signals were mostly uneven and presented cavernous appearances in 4 patients. Conclusion ABCs has characteristic imaging appearance. Respectively, X-ray plain film,CT or MRI plays different role in reviewing the image feature of the ABCs and the combination of these three imaging methods may improve the accuracy rate of preoperative diagnosis of ABCs. [Key words] anuerysmal bone cyst; imaging diagnosis 动脉瘤样骨囊肿是一种病因不明的肿瘤样病变，回顾性分析2001～2006年期间在工作中遇到并经病理证实的11例ABC病人，发现术前诊断为ABC的病人仅4例（诊断正确率为37%），其余诊断为骨巨细胞瘤。ABC的病理特点及生物学行为不同于骨巨细胞瘤和其他骨肿瘤，其手术治疗方案也不尽相同，本文通过分析ABC的影像学特征并结合有关文献资料进行探讨，以期提高ABC术前诊断正确率及其与骨巨细胞瘤的鉴别。 材料与方法 1.一般资料 选择2001-01～2006-6期间经病理证实的11例ABC病人，男7例，女4例，年龄9-65岁，平均年龄37.9岁。病程1周～2年。临床主要表现为患病部位疼痛不适，疼痛性质一般为胀痛、隐痛、酸痛，查体可见局部软组织膨隆肿胀，可扪及质硬肿块，有时可有波动感，其中1例以病理骨折为首发症状。所有病人均采用X平片、CT、MR三者中的一项或两项进行检查。 2.检查方法 2.1平片DR/CR检查者5例，使用SIEMENS Aristos MX DR或DELL GX270 CR摄片机，常规摄取病变部位的正侧位，选择性摄取切线位。 2.2CT检查者5例，使用GE Lights