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目的探讨螺旋CT及三维重建在颌骨造釉细胞瘤中的应用价值。方法回顾性分析11例经手术病理证实的颌骨造釉细胞瘤,均行螺旋CT扫描并行三维重建后处理,观察病变的部位、形态、内部结构及邻近结构侵犯等特征。结果 11例患者中,5例病灶位于下颌磨牙区、4例位于下颌体部、2例位于上颌骨。多房型6例,其中3例呈肥皂泡状、3例呈蜂窝状。骨性房间隔可完整或不完整。单房型5例。5例有不同程度牙根吸收。11例病灶均可见周围骨质呈膨胀变薄。7例病灶可见囊壁周围骨质缺损,无硬化缘;2例穿破邻近骨皮质形成软组织肿块。1例侵及上颌窦,5例侵及下颌管。6例病灶呈均一囊性密度,4例呈软组织密度,1例术后10年复发病例呈囊实混杂密度。结论螺旋CT三维成像可直观了解病变在三维立体空间的实际大小、形态、位置、内部结构、周围骨质破坏、牙根吸收及周围组织结构的立体解剖关系,对提高造釉细胞瘤的术前诊断正确率有重要价值,为制订手术方案和放疗计划提供了客观依据。
Objective To investigate the value of spiral CT and three-dimensional reconstruction in ameloblastoma of the jaw. Retrospectively analyzed 11 patients with pathologically confirmed mandibular ameloblastoma, spiral CT scan were performed after three-dimensional reconstruction processing in parallel, characterized in lesions were observed location, shape, internal structure and adjacent structure assault. Results Of the 11 patients, 5 lesions were located in the mandibular molars, 4 in the mandible and 2 in the maxilla. Multi-chamber type in 6 cases, of which 3 were soap bubbles, three were honeycomb. Bony atrial septum may be complete or incomplete. Single-type in 5 cases. Five cases had different degrees of root resorption. All the 11 lesions showed swelling and thinning around the bone. Seven cases of lesions showed cystic bone around the wall, no sclerosis; 2 cases of penetrating cortical bone adjacent to the formation of soft tissue mass. One case invaded the maxillary sinus and 5 cases invaded the mandibular canal. Six cases showed homogeneous cystic densities, four cases showed soft tissue densities, and one case had recurrent cystic densities after 10 years. Conclusion Spiral CT imaging can intuitively understand the actual size of the lesion in the three-dimensional space, shape, location, internal structure, destruction of the surrounding bone, root absorption and dimensional anatomic relationship of the surrounding structure, for improving preoperative diagnosis ameloblastoma Correct rate has important value, which provides an objective basis for formulating surgical plans and radiotherapy plans.