【作者】 杨大海； 李静远； 刘晓勇； 王松灵；

【Author】 Dahai Yang, Jingyuan Li, Xiaoyong Liu, Songlin Wang Faculty of stomatology Capital University of Medical Sciences

【机构】 首都医科大学口腔医学院；

【摘要】 目的观察牙源性角化囊肿的X线表现,并探讨其X线表现的病理学基础。方法牙源性角化囊肿患者30例,男性19例,女性11例,初诊年龄14—40岁,平均27.9岁,上颌5例,下颌25例,单发28例,多发2例。分析牙源性角化囊肿的X线表现,并从其病理特性分析其病理学基础。结果牙源性角化囊肿的X线表现以单房囊性骨密度减低区多见,骨密度减低区与其内部含有大量囊液有关;大部分边缘无分叶,少数边缘呈分叶状,但元切迹,若出现切迹多与局部成釉细胞瘤变有关;角化囊肿周缘有骨硬化边缘包绕,病理上囊壁腔面多衬有完整的角化上皮层,有时骨硬化边缘模糊,与囊肿壁有炎症细胞浸润、继发感染有关;角化囊肿有沿颌骨长轴发展的趋势,与囊肿上皮沿骨小梁呈指突状生长有关;角化囊肿内有时可见弥散的片状密度增高影像,认为与囊肿上皮表面呈正角化,且大量的角化物呈葱皮样有关;上、下颌骨多发的角化囊肿表现,与囊肿上皮分化较幼稚有关。结论牙源性角化囊肿的X线表现有其相应的病理学基础,可以通过其X线表现和病理学表现反映其病变特性。更多还原

【Abstract】 Objective To observe the radiographic appearance of odontogenic keratocyst (OKC) and investigate the pathologic basis of its radiographic pattern.Methods Thirty cases of OKC were studied,including 19 male patients and 11 female patients, 5 maxillary lesions and 25 mandibular lesions, 28 solitary lesions and 2 multiple lesions, aged from 14 to 40 years. The radiographic pattern of OKC was analyzed and related to the pathologic findings.Results OKC usually appeared as a unilocular radiolucency, and radiolucent appearance resulted from liquid material derived from the epithelial lining. OKC often showed a smooth round or oval shape. In some cases.it might have a scalloped outline. OKC usually had a cortical border that arose from intact keratinized epithelial lining inside the cyst. The cortical border was clear unless OKC had secondary infection. An important characteristic of the OKC was its propensity to grow along the body of mandible, causing minimal expansion, which was related to the pattern of finger-like growth of cystic epithelia between the trabeculaes. The presence of internal keratin might increase the radiopacity of OKC. The multiple occurance of OKC might be related to immature differentiation of cystic epithelia.Conclusion The radiographic features of OKC can correspond to pathologic patterns. Therefore,the biologic features of OKC may be illuminated via its radiographic and pathologic patterns.更多还原