MSCT在邻关节骨囊肿诊断中的应用价值
Application of MSCT Scanning in the Diagnosis of Juxta-Articular Bone Cyst
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摘要: 目的: 探讨邻关节骨囊肿的MSCT表现,提高对该病的术前诊断能力。方法: 回顾性分析经手术病理证实的32例邻关节骨囊肿的临床及CT薄层扫描、多平面重组(MPR)表现。男20例,女12例,平均年龄42岁。结果: 32例均为单发病变,共32个病灶,其中股骨头8个,胫骨近端8个,距骨6个,胫骨远端3个,腕月骨3个,股骨远端、髋臼、肱骨近端和腕舟骨各1个。病灶均位于骨内邻近关节面,病灶大小介于0.8cm×1.2cm~2.5cm×2.9cm之间。单房型26例,CT表现为圆形、类圆形或不规则形囊样低密度区,边缘清晰,均有薄层完整硬化边,相邻关节间隙无明显改变;多房型6例,病灶内有粗细不等的骨性间隔。病灶CT值20~60Hu,3个病灶内见细小气体密度影。穿透型18例,表现为病灶通过邻关节面裂隙与关节腔相通或病灶与关节旁软组织腱鞘囊肿相连;特发型14例,表现为骨内单一病灶,骨外结构正常。结论: 邻关节骨囊肿有其特殊发病部位,CT表现典型,结合发病年龄和临床症状,可以作出正确的术前诊断。Abstract: Objective: To evaluate the MSCT features of the juxta-articular bone cyst(intraosseous ganglion),and improve imaging diagnosis ability of disease.Methods: The clinical and MSCT findings of 32 patients with intraosseous ganglion confirmed by operation and pathology were retrospectively analyzed.20 males,12 females,mean age 42 years old.Results:There were 32 lesions,including 8 femoral head,8 proximal ends of tibia,6 talus,3 distal ends of the tibia,3 lunate,1 distal ends of the femoral,1 acetabula,1 proximate end of the humerus,and 1 scaphoid.32 lesions located in the adjacent articular surface,the size ranged from 0.8cm × 1.2cm~2.5cm × 2.9cm.Among the 32 lesions,28 lesions were unilocular,28 lesions revealed a round,ellipsoidal or irregular low-density area with a full rim of sclerotic on CT,no joint spaces were abnormal;6 lesions were multiloculated-cystic,showed thick or thin septa at lesions.18 cases were the penetrability,showed an intraosseous ganglion communication with adjacent joint or with intrasoft-tissue ganglion on CT;14 cases were idiopathic,showed a single lesion in the adjacent articular surface.Conclusion: The characteristic locations and the typical MSCT features combined with the age of patient and clinical manifestations,it is possible to make a correct diagnosis of intraosseous ganglion.