CAJ | 학술논문

目的分析股骨颈骨样骨瘤的临床及影像特点,提高对本病的诊断水平.方法回顾性分析21例经手术病理证实的股骨颈骨样骨瘤的临床及影像学资料.其中男18例、女3例；年龄7～26岁,中位年龄13岁.所有病例均行常规X线及CT检查,其中同时行CT增强检查10例,行MR检查4例.结果 19例表现为髋关节疼痛,其中夜间痛11例,8例服用水杨酸类药物可缓解；另外2例仅表现为跛行.病程2个月至4年6个月,中位时间12个月.X线平片:21例中仅有10例显示瘤巢,18例股骨颈内下方呈不同程度的骨质硬化.CT:21例均清楚显示瘤巢,其中骨皮质型8例,骨膜下型6例,骨内膜型7例；20例骨质硬化均位于瘤巢下方,即髋关节囊外的股骨前内侧骨皮质；“血管沟征”19例.MRI:4例均可显示瘤巢；骨质硬化在各序列上均呈低信号；关节积液3例,骨髓水肿4例,滑膜增厚2例.结论股骨颈骨样骨瘤的临床表现不典型,但其影像表现具有一定的特征性,瘤巢位于关节内,而骨质硬化主要发生于关节外的股骨前内侧骨皮质.CT扫捕仍然是显示瘤巢的最佳方法.
목적 분석고골경골양골류적림상급영상특점,제고대본병적진단수평.방법 회고성분석21례경수술병리증실적고골경골양골류적림상급영상학자료.기중남18례、녀3례；년령7～26세,중위년령13세.소유병례균행상규X선급CT검사,기중동시행CT증강검사10례,행MR검사4례.결과 19례표현위관관절동통,기중야간통11례,8례복용수양산류약물가완해；령외2례부표현위파행.병정2개월지4년6개월,중위시간12개월.X선평편:21례중부유10례현시류소,18례고골경내하방정불동정도적골질경화.CT:21례균청초현시류소,기중골피질형8례,골막하형6례,골내막형7례；20례골질경화균위우류소하방,즉관관절낭외적고골전내측골피질；“혈관구정”19례.MRI:4례균가현시류소；골질경화재각서렬상균정저신호；관절적액3례,골수수종4례,활막증후2례.결론 고골경골양골류적림상표현불전형,단기영상표현구유일정적특정성,류소위우관절내,이골질경화주요발생우관절외적고골전내측골피질.CT소포잉연시현시류소적최가방법.
Objective To evaluate the clinical and imaging characteristics of osteoid osteoma in femoral neck and to improve diagnostic accuracy of this disease.Methods Twenty-one patients (18 males and 3 females,age,7-26 years,median age,13 years) with pathologically proven osteoid osteoma of the femoral neck were retrospectively analyzed for their clinical profile and radiologic features.CT and X-ray examinations were performed in all patients,10 of them pefformed post-contrast CT scan and 4 of them performed MRI examinations.Results Nineteen patients had hip pain (pain worse at night in 11,and 8 received salicylates treatment with good response),and 2 patients only with intermittent claudication.The duration ranged from 2 months to 54 months (median duration 12 months).X-ray: Nidus was seen on plain film in 10 cases,18 cases showed different degrees of bone sclerosis of the nidus.CT: Nidus was demonstrated in all cases.Among them,8 were intracortical,6 were subperiosteal,7 were endosteal.Twenty cases showed different degrees of bone sclerosis of the nidus-extra-articular anteromedial cortical surface of the femur neck.Nineteen cases showed "vascular groove sign".MRI: Nidus was seen in 4 cases.Bone sclerosis was low signal on all sequences.Three cases had joint effusion,4 cases had bone marrow edema,and 2 cases had synovial thickening.Conclusions Although osteoid osteoma of femoral neck has non-specific clinical features,the radiographic findings are usually typical.The nidus of osteoid osteoma is often located within the joint.Bony sclerosis occurs at the area of extra-articular anteromedial cortical surface of the femur neck.CT examination remains an optimal method to identify the nidus.