CAJ | 학술논문

目的分析距骨肿瘤及瘤样病变的病种分布及其影像学表现.方法对2002年3月至2013年9月经手术及病理证实的33例距骨肿瘤及瘤样病变的影像学表现进行回顾性分析,男24例,女9例.所有病例均行X线检查,23例行CT检查,11例行MR检查.结果 33例距骨病变中成软骨细胞瘤7例(21.2％),骨巨细胞瘤7例(21.2％,其中1例为术后复发病例),骨软骨瘤6例(18.2％),骨样骨瘤2例(6.1％),邻关节囊肿7例(21.2％),骨纤维结构不良2例(6.1％),骨囊肿1例(3％),骨恶性纤维组织细胞瘤1例(3％).合并病理性骨折6例.成软骨细胞瘤、骨巨细胞瘤、邻关节囊肿、骨纤维结构不良、骨囊肿等良性肿瘤及瘤样病变的X线、CT表现为囊性骨破坏.成软骨细胞瘤好发于距骨体后部(57％),轻度膨胀,边缘轻度硬化.骨巨细胞瘤边缘呈不规则硬化,可见骨嵴.MRI依病灶组成可有不同表现,通常为T1WI呈等、低信号,T2WI呈高信号.骨软骨瘤表现为与距骨相连的骨性突起,可见软骨帽钙化.距骨恶性纤维组织细胞瘤的X线、CT均呈溶骨性破坏,可见软组织肿块,无骨膜反应及肿瘤骨;MRI T1WI呈等、低信号,T2WI呈等、高信号,肿瘤侵犯范围显示清晰.结论距骨肿瘤及瘤样病变少见且病种较多,良性多于恶性.成软骨细胞瘤、骨巨细胞瘤、骨软骨瘤、骨样骨瘤、邻关节囊肿相对好发,影像学表现有一定的特征.恶性肿瘤虽少,但仍有发生的可能.
목적 분석거골종류급류양병변적병충분포급기영상학표현.방법 대2002년3월지2013년9월경수술급병리증실적33례거골종류급류양병변적영상학표현진행회고성분석,남24례,녀9례.소유병례균행X선검사,23례행CT검사,11례행MR검사.결과 33례거골병변중성연골세포류7례(21.2％),골거세포류7례(21.2％,기중1례위술후복발병례),골연골류6례(18.2％),골양골류2례(6.1％),린관절낭종7례(21.2％),골섬유결구불량2례(6.1％),골낭종1례(3％),골악성섬유조직세포류1례(3％).합병병이성골절6례.성연골세포류、골거세포류、린관절낭종、골섬유결구불량、골낭종등량성종류급류양병변적X선、CT표현위낭성골파배.성연골세포류호발우거골체후부(57％),경도팽창,변연경도경화.골거세포류변연정불규칙경화,가견골척.MRI의병조조성가유불동표현,통상위T1WI정등、저신호,T2WI정고신호.골연골류표현위여거골상련적골성돌기,가견연골모개화.거골악성섬유조직세포류적X선、CT균정용골성파배,가견연조직종괴,무골막반응급종류골;MRI T1WI정등、저신호,T2WI정등、고신호,종류침범범위현시청석.결론 거골종류급류양병변소견차병충교다,량성다우악성.성연골세포류、골거세포류、골연골류、골양골류、린관절낭종상대호발,영상학표현유일정적특정.악성종류수소,단잉유발생적가능.
Objective To research the variety and the imaging features of bone tumor and tumor-like lesions in the talus.Methods The imaging features of 33 cases of tumor and tumor-like lesions in the talus were reviewed retrospectively.All cases were confirmed by operation and pathology,All of 33 cases were performed X-ray examination,23 cases were examined by CT,and 11 cases were taken by MR.Results In 33 cases,24 cases were males,9 cases were females; including 7 cases of chondroblastoma(21.2％),7 cases of giant cell tumor(21.2％)(1 case of recurrence),6 cases of osteochondroma(18.2％),2 cases of osteoid osteoma(6.1％),7 cases of adjacent joint bone cyst(21.2％,2 cases of fibrous dysplasia of bone(6.1％),1 case of bone cyst(3％),1 case of malignant fibrous histiocytoma(MFH) of bone(3％).6 cases showed pathological fractures.The X-ray and CT imaging features of chondroblastoma,giant cell tumor,adjacent joint bone cyst,fibrous dysplasia of bone,bone cyst demonstrated cystic bony destruction.The common location of chondroblastoma were the posterior of talus(57％),expanding growth slightly,margin were mild osteosclerosis.The margin were osteosclerosis irregularly and osteal ridges showed in giant cell tumor.MRI features were different on pathologic basis,isointense and hypointense signal on T1WI and hyperintense signal on T2WI usually.The osteochondroma showed osseous protuberance connecting the talus,some cases showed calcification in the cap.The imaging of MFH in the talus X-ray and CT showed ill-defined osteolytic bony destruction,soft tissue-mass,no periosteal reactions and bone formation.MRI showed isointense and hypointense signal on T1WI and isointense and hyperintense signal on T2WI.The extent of tumour invasion clearly displayed.Conclusion Tumor and tumor-like lesion in the talus were rare.But there are great varieties.The benign tumor was more common than malignant tumor.Chondroblastoma,giant cell tumor,osteochondroma,osteoid osteoma and adjacent joint bone cyst were relatively common and had some imaging features.Malignant tumor rarely happened in the talus,but it is possible.