【摘要】 目的探讨胫骨灶性坏死性疲劳骨折的影像学诊断,并与骨样骨瘤相鉴别诊断。方法回顾分析7例胫骨灶性坏死性疲劳骨折的影像学表现,2例经手术证实,5例经随访观察1年以上自愈。全部摄小腿正侧位片,其中4例行CT检查、1例行MR检查。结果胫骨中段前部或前外侧局限性实体样骨膜增生,于增厚的骨皮质内见楔形、小点状或小囊状溶骨灶,3例伴有或曾有横行透亮线,5例皮质表面可见不同程度的尖角样翘起。7例均曾被误诊为骨样骨瘤。结论疲劳性骨折可发生局灶性坏死,病灶形态随病程变化为"由线到圆",后者可酷似骨样骨瘤。疲劳骨折的"瘤巢样病灶"边缘模糊,局部皮质有尖角样突起。更多还原

【Abstract】 Objective To investigate the imaging diagnosis of focal necrotic fatigue fracture,and to distinguish it from teoid osteoma.Methods Imaging features of 7patients with persisting focal necrotic fatigue fracture in tibia were analyzed retrospectively.In addition,2patients were confirmed by operation,and 5patients were spontaneous cured via follow-up observation for more than one year.Anterioposterior and lateral films on tibia were obtained in all the patients.Three of them underwent CT scan,and 1of them underwent MR scan.Results There was focal and noumenal periosteal proliferation in the anterior and lateral parts of middle tibia,and wedge-shaped,small plaguliform or cystiform osteolytic lesions were found in the thickened cortex of bone.Laterigrade lucent lines were found in 3patients,and varying degrees of angled prominency was found in the cortex surface in 5patients.All the 7patients were misdiagnosed as teoid osteoma.Conclusion Focal putrescence can be found in fatigue fracture,which shows great resemblance with teoid osteoma.The lesion morphology changes from "line"into"circular".The"tumor nidus"in fatigue fracture is vague,and angled prominency can be found.更多还原