【摘要】 目的探讨腕骨外生骨软骨瘤的发病特点和影像学诊断方法。方法回顾性地分析了17例多发性骨软骨瘤的病例,其中9例在疾病的不同阶段均可见腕骨周围的异常钙化影。通过对这9例患者长期随访的影像学资料进行追踪对比、分析,总结腕骨外生骨软骨瘤的发病特点和影像学的诊断方法。结果本组病例观察到腕骨病变的年龄为3．5～8．0岁,平均[(5．7±1．6)岁,x±s,下同],有5例患者在10．0～15．0岁．平均(12．0±1．9)岁以后,在X线平片中就难以分辨骨软骨瘤的病变了,有3例患者在骨软骨瘤的X线影像与腕骨融合后仍可见腕骨显著的畸形。CT扫描有助于发现某些已经与腕骨融合的瘤体,MRI对腕骨外生骨软骨瘤的诊断并不比CT更敏感。腕骨的外生骨软骨瘤可以累及除豌豆骨外的所有腕骨,其中头状骨受累最为常见,瘤体可出现于一侧或双侧腕关节,受累侧的尺、桡骨和(或)掌、指骨也都有瘤体分布。在腕关节中,瘤体可同时累及两块腕骨,也可有多个瘤体累及一块腕骨。腕骨的瘤体极少影响腕关节的功能。结论腕骨外生骨软骨瘤在多发性骨软骨瘤的患者中较为常见,采用多体位X线平片在患儿的青少年时期较为容易发现异常病变影,CT扫描有助于定位并明确诊断,此类疾病多无需手术治疗。更多还原

【Abstract】 Objective To clarify the disease entity and the image diagnosis methods for carpal exostosis. Methods Seventeen multiple exostoses cases were studied retrospectively.Abnormal calcification shadows around carpal bones was found in 9 of these patients during their juvenile.These patients’ long term follow-up materials, including both clinical and image data,were carefully investigated.Remits The age of the initial abnormal image findings ranged from 3.5 to8 years old (5.7±1.6 years).In5 cases,the abnormal images disappeared at the age of 10 to 15 years old (12.0±1.9 years).Signs of the disease were not recognizable on X-rays of 5 patients when they were older than 10 to 15 years (average 12.0±1.9 years).In 3 cases,there were some obvious consequent carpal deformities after the tumor was fused to the carpal bones.CT was helpful for the localization and diagnosis of some difficult cases.In this group,carpal exostesis involved almost all the carpal bones except pisiform.The tumors were found around one or two carpal bones on one side or on both sides.Carpal exostosis seldom affected the involved wrist functions.Conclusion Carpal exostosis was quite common in the multiple exestoses cases.Its abnormal images could be found with different views of roentgenograph at patients’ juvenile.CT was helpful for localization and diagnosis.No operation was needed in most cases.更多还原