脊椎骨纤维异常增殖症的CT诊断

李杰; 吕梁

中国临床医学影像杂志 ›› 2009, Vol. 20 ›› Issue (5) : 316-318.

论著

脊椎骨纤维异常增殖症的CT诊断

李杰，吕梁

作者信息 +

CT imaging diagnosis of fibrous dysplasia of vertebrae

LI Jie, LV Liang

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文章历史 +

摘要

目的：分析脊椎骨纤维异常增殖症（FDB）的CT表现，总结本病的CT表现特征。资料与方法：回顾性分析经手术病理证实的6例脊椎FDB的CT影像资料。男4例，女2例，年龄31～49岁，平均39岁。所有病例均行CT检查，1例利用二维多平面重组技术（MPR）进行冠状位和矢状位重建。结果：本组中单骨型5例，其中单骨单灶3例，单骨多灶2例；多骨型1例。2例发生于胸椎，4例发生于腰椎。CT表现为单骨局灶性、多发性或多骨囊状低密度病损，周围骨质硬化，透亮区内见磨玻璃影和致密骨化。所有病例均见椎体内有病灶分布，1例单骨多灶型伴附件受累，而1例多骨型则有附件及邻近肋骨、关节受累。结论：脊椎FDB具有不同于典型部位FDB的CT表现特点，同时还有FDB的共同影像表现特点。掌握这些特点有助于提高对本病的认识，作出正确诊断。

Abstract

Objective: To analyse the CT imaging findings of fibrous dysplasia of vertebrae and evaluate the imaging characteristics. Materials and Methods: CT imaging findings in 6 cases with pathologically confirmed fibrous dysplasia of vertebrae were reviewed retrospectively. Among all the patients, 4 cases were male and others were female. The range of age was 31~49 years. All cases were examined by CT plain scan, 1 case was processed by MPR image reconstruction of coronal and sagittal plane. Results: Of 6 cases, 5 patients had monostotic fibrous dysplasia including 3 patients with solitary lesion and another 2 with multiple lesions, 1 patient had polyostotic fibrous dysplasia. Among them, the lesions of 2 cases were located in thoracic vertebra, 4 in lumbar vertebra. CT showed monostotic with focal lesion, monostotic with multiple lesions and polyostotic cystic radiolucent lesions with sclerotic margin, internal “ground glass”-like density or osteoid high density, but the contour of vertebral bodies was normal. The lesions located in vertebral body can be seen in all cases, one case of monostotic fibrous dysplasia with multiple lesions had involvement of appendage whereas the lesion of the polyostotic fibrous dysplasia case affected appendage, proximal rib and articulation. Conclusion： Fibrous dysplasia of vertebrae shows distinctive CT imaging features that are different from fibrous dysplasia of bone in typical sites. And it could display some collective features of fibrous dysplasia of bone. These features can be helpful to make a correct diagnosis.