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目的:比较下颌骨髁突骨软骨瘤和单侧下颌骨髁突增生的CT表现特点。方法:对2005—2010年上海交通大学医学院附属第九人民医院口腔颌面外科收治的下颌骨髁突骨软骨瘤11例和单侧下颌骨髁突增生8例患者的CT影像学资料进行评价,评价指标包括病变髁突大小、病变范围以及病变周围软硬组织改变。结果:11例下颌骨髁突骨软骨瘤病例CT显示肿瘤与病变髁突无明显分界(8/11)或与患侧髁突有蒂相连(3/11);肿瘤骨皮质及骨髓腔均与患侧髁突相续,瘤体表面均有特征性薄层软骨帽覆盖,瘤体外周密度通常高于中心;瘤体周围均有薄层软组织包绕。患侧颞骨关节面表面均有明显矿化,且因受瘤体压迫改建而较对侧平坦,患侧关节上、下腔间隙较对侧明显变窄;肿瘤生长方向不尽相同。8例单侧下颌骨髁突增生病例CT显示髁突颈部和(或)下颌支延长,髁突形状改变;增生的髁突外周骨皮质均有不同程度的骨化,硬化层厚度较对侧大;骨髓腔密度较不均匀。结论:CT检查能有效提供病变髁突及其周围软硬组织情况,为鉴别诊断下颌骨髁突骨软骨瘤和单侧下颌骨髁突增生提供良好的依据。
OBJECTIVE: To compare CT features of mandibular condylar osteochondroma and unilateral mandibular condylar proliferation. Methods: CT images of 11 cases of mandibular condylar osteochondroma and 8 cases of unilateral mandibular condyle hyperplasia were collected from the Department of Oral and Maxillofacial Surgery, Shanghai Ninth People’s Hospital Affiliated to Shanghai Jiaotong University School of Medicine from 2005 to 2010.Results: Evaluation criteria included the size of the condyles, the extent of the lesion, and the changes of the soft and hard tissue around the lesion. Results: 11 cases of mandibular condyle osteochondroma cases showed no obvious demarcation between the tumor and condyles (8/11) or pedicle condyles (3/11). The cortical and medullary cavity The ipsilateral condyles continued, the surface of the tumor was covered by the characteristic thin layer cartilage cap, the peripheral density of the tumor was usually higher than the center, and the surrounding of the tumor was surrounded by the thin layer of soft tissue. The surface of the affected side temporal articular surface were significantly mineralized, and because of compression by the tumor rather than the contralateral flat, ipsilateral superior and inferior space was significantly narrower than the contralateral; tumor growth direction is not the same. 8 cases of unilateral mandibular condyle hyperplasia cases CT showed condylar neck and (or) mandibular branch extension, condylar shape changes; proliferative condyle peripheral cortical bone have varying degrees of ossification, the thickness of the hardened layer than the contralateral Large; bone marrow density is less uniform. Conclusion: The CT examination can effectively provide the condyles and the surrounding soft and hard tissue, and provide a good basis for differential diagnosis of condylar osteochondroma and unilateral mandibular condylar proliferation.