应用MRI评价扁平颅底

扁平颅底是指颅底骨质的异常平坦，可发生于多种先天性疾病（如颅面畸形、骨发育不良、颅锁骨发育不全和Chiari畸形）或后天性疾病（如Paget病、骨软化、佝偻病和创伤），影像学上表现为基底角变钝。最早在平片上测量基底角，目前CT和MRI已成为检查头颅的常规方法。作探讨MRI测量基底角的可靠性，并提出一种改良的测量方法。     

Van Buchem''''s病的X线特征和头颅CT表现

Van Buchem's病是一罕见的遗传性硬化性骨发育不良。特点是:常累及颅骨、下颌骨和长骨,后者表现为骨内膜增生,好发于骨干部位。作者报告1例由于颅底骨硬化导致孔道狭窄引起视力和听力症状,并描述了CT表现。患者为一女婴,生后即表现前额突出,上唇长而前倾,皮肤粗糙并有皱纹。一年后胸部X线片显示锁、肋、脊椎和肩胛骨有硬化。体层和CT显示颅底骨广泛硬化,内耳道     

致密性骨发育不全1例

女,14岁,主诉左髋痛1年.查体:身高124 cm,头大面小,均匀性侏儒,问答切题.X线检查:双侧上下肢、脊柱、肋骨、骨盆及头颅骨密度弥漫性增高,骨皮质增厚,骨髓腔狭窄;颅骨发育不全,前、后囟未闭,明显扩大呈湖泊状,见缝间骨,下颌角消失;双侧锁骨远端发育不全,肩锁关节间隙增大;双手末节指骨末端发育不全,变尖、部分缺损;脊柱椎体呈"夹心椎".     

肺不发育的X线及CT表现(附3例报告)

目的探讨肺不发育的X线及CT表现,提高对本病的认识及影像诊断水平。方法分析3例经临床证实的肺不发育的X线及螺旋CT表现。结果 X线可见患侧肺野透过度明显减低,未见明显肺纹理;CT可见患侧主支气管变短,支气管分支发育不全或畸形闭塞;健侧或邻近肺叶代偿性膨胀。结论肺不发育的X线及CT表现具有一定特征性,对诊断有一定价值。     

儿童单灶性骨嗜酸性肉芽肿影像学特征分析

目的探讨儿童单灶性骨嗜酸性肉芽肿的影像学特征。方法回顾性分析2008年1月~2015年12月间25例经组织病理学诊断的儿童单灶性骨嗜酸性肉芽肿的影像学资料。结果男19例,女6例。年龄2~14岁,平均年龄6岁。长骨14例,脊柱6例,颅骨3例,锁骨1例,髂骨1例。长骨病变主要表现为骨质破坏、邻近骨皮质"扇贝样"压迹、骨膜反应和软组织肿胀或肿块。部分病变可见骨皮质钻孔样破坏、破坏区内死骨及周围硬化缘。椎体病变主要表现为椎体破坏、塌陷,呈"扁平椎"改变,部分可见椎旁软组织肿块,但椎间隙保持正常。颅骨病变主要表现为穿凿样骨质破坏,边界清晰,可见"斜坡征"。髂骨及锁骨病变缺乏特异性。病变在MRI多呈T_1WI等或稍低信号,T_2WI不均匀高信号。结论长骨的骨皮质"钻孔样"破坏、颅骨的"穿凿样"破坏及椎体的"扁平椎"是本病的特征性影像学征象。X线平片诊断价值有限,CT可清晰显示骨膜反应及骨质硬化,尤其是骨皮质细微的骨侵蚀。MR有助于显示X线及CT尚无异常表现的早期骨髓受累,并确定骨髓水肿及软组织病变范围。     

儿童白血病侵犯颅骨2例

目的:提高对儿童白血病侵犯颅骨的X线和CT表现的认识。材料和方法:回顾性分析2例经骨髓细胞学检查证实为白血病的颅骨X线和CT表现。结果:2例中1例X线片表现为颅骨多发不规则低密度灶,边缘欠清晰,周围无明显硬化,同时伴双侧髂棘下、股骨大转子多发小囊状骨质吸收,边缘欠清,骨皮质无中断;另1例颅脑CT平扫颅窗显示脑实质未见明显异常,骨窗显示枕骨内外板增厚、局部骨质破坏、并见高密度坏死骨。2例均为L2型急性淋巴细胞白血病(ALL-L2)。结论:儿童白血病侵犯颅骨的X线、CT表现具有多样性,结合骨髓细胞形态学检查可以做到早期诊断。     

颅骨—锁骨发育不全三例报告

颅骨—锁骨发育不全症,又称遗传性颅骨锁骨发育不全,骨-牙形成障碍,全身性骨发育障碍,骨盆、颅锁骨发育不全。我们发现一家族3个病例,报道如下: 例1,男,15岁。生后发现两肩内收隆起,活动范围     

骨原发性非何杰金氏淋巴瘤X线与CT表现探讨(附8例报告)

目的　探讨骨原发性非何杰金氏淋巴瘤的X线与CT表现及诊断要点。方法　回顾性分析 8例 (B细胞源性 7例 ,T细胞源性 1例 )经临床和病理确诊的X线及CT表现。结果　 6例为单骨 (肱骨、股骨上端、肋骨、髂骨、锁骨及胸椎各 1例 ) ,2例为多骨 (1例侵犯股骨远端及胫骨近段 ,1例侵犯髂骨及耻骨 )。X线表现为浸润型 4例 ,溶骨型、硬化型、混合型和囊状膨胀型各 1例。全部有软组织肿块 ,2例有骨膜反应 ,2例合并病理性骨折。结论　本病常侵犯单骨 ,多表现为虫蚀样浸润性骨破坏和溶骨性骨破坏 ,有软组织肿块。X线诊断困难 ,需密切结合临床和病理     

多发性骨嗜酸性肉芽肿的影像学表现(附11例分析)

目的:探讨多发性骨嗜酸性肉芽肿的影像学表现特征.方法:回顾分析经手术病理证实的11例多发性骨嗜酸性肉芽肿的X线、CT和MRI资料.结果:全部病例共计41处病灶,其中脊椎13处、颅骨11处、骨盆6处、锁骨4处、肋骨4处、四肢长骨3处.病灶最多之病例累及12骨,共16处病灶.本病基本影像学表现相似,但不同部位及不同病程影像学表现具有一定特征性.结论:X线平片是不可缺少的首选检查.CT在显示复杂骨骼解剖、病灶细微结构方面优于X线平片,有利于早期发现病变及帮助定性与鉴别诊断.MRI对于准确显示病变范围及邻近组织改变有明显优势.     

文摘

[英]/K oenigsberg RA…//A JNR.-2005,26(1).-89～92扁平颅底是指颅底骨质的异常平坦,可发生于多种先天性疾病(如颅面畸形、骨发育不良、颅锁骨发育不全和Chiari畸形)或后天性疾病(如Paget病、骨软化、佝偻病和创伤),影像学上表现为基底角变钝。最早在平片上测量基底角,目前CT和M R I已成为检查头颅的常规方法。作者探讨M RI测量基底角的可靠性,并提出一种改良的测量方法。作者搜集了200例成人、50例儿童的资料,均为正常人或无颅骨发育畸形者。采用1.5T M R设备于正中矢状面T1W I上使用2种方法测量基底角,第1种方法为基于传统的…     

Cleidocranial dysplasia: radiological appearances on dental panoramic radiography.

OBJECTIVE: To report the effectiveness of dental panoramic radiography in identifying features pathognomonic for cleidocranial dysplasia. METHODS: Panoramic radiographs of nine male Caucasian patients with cleidocranial dysplasia are analysed. RESULTS: In addition to the established dental complications of failure of eruption of the permanent dentition and multiple supernumerary teeth, morphological abnormalities of the maxilla and mandible, particularly in the ascending ramus and coronoid process were present. CONCLUSION: Dental panoramic radiography is a valuable adjunct in confirming the diagnosis of cleidocranial dysplasia.     

Tomografía computarizada fetal de baja dosis para diagnosticar displasias óseas

We present a case of cleidocranial dysplasia diagnosed by low-dose fetal computed tomography (CT) in the 25th week of gestation. Severe bone dysplasia was suspected because of the fetus’ low percentile in long bones length and the appearance of craniosynostosis on sonography. CT found no abnormalities incompatible with life. The effective dose was 5 mSv, within the recommended range for this type of examination. Low-dose fetal CT is a new technique that makes precision study of the bony structures possible from the second trimester of pregnancy. In Spain, abortion is legal even after the 22nd week of gestation in cases of severe fetal malformations. Therefore, in cases in which severe bone dysplasia is suspected, radiologists must know the strategies for reducing the dose of radiation while maintaining sufficient diagnostic quality, and they must also know which bony structures to evaluate.     

新生儿颅骨骨膜下血肿的X线和CT诊断

目的:探讨新生儿颅骨骨膜下血肿的X线和CT诊断。材料和方法:回顾性分析68例新生儿颅骨骨膜下血肿的X线/CT表现。结果:骨膜下血肿在X线平片上未见骨化21例、边缘骨化25例、完整骨壳和完全骨化22例。CT显示血肿骨化明显早于X线平片。血肿骨化广基底与颅骨外板相接、与颅板呈钝角相交,不跨越颅缝。结论:新生儿颅骨骨膜下血肿有其特征性的X线和CT表现,并可确诊。     

Camurati-Engelmann disease: a late and sporadic case with metaphyseal involvement

A 40-year-old white man with a 3-year history of mild to severe right thigh and knee pain was referred for radiographic investigation. Radiographs show a fusiform, bilaterally symmetrical enlargement of the diaphyses and metaphyses of the long bones (femur, tibia, fibula, radius and ulna). A narrowed medullary cavity is illustrated on CT scan of the femur. All bones show periosteal and endosteal bone formation. There is no history of familial involvement, trauma, infection or systemic illness. Blood chemistry could not point out any abnormality. Radiographic findings and clinical history suggest the diagnosis of Camurati-Engelmann disease, also known as progressive diaphyseal dysplasia (PDD). This case is of interest because of its rare metaphyseal involvement, mild form and sporadic presentation. Received: 4 December 1997; Revision received: 3 March 1998; Accepted: 5 March 1998     

Stature estimation from skull measurements using multidetector computed tomographic images: A Japanese forensic sample

The aim of this study was to assess the correlation between stature and cranial measurements in a contemporary Japanese population, using three-dimensional (3D) computed tomographic (CT) images. A total of 228 cadavers (123 males, 105 females) underwent postmortem CT scanning and subsequent forensic autopsy between May 2011 and April 2015. Five cranial measurements were taken from 3D CT reconstructed images that extracted only cranial data. The correlations between stature and each of the cranial measurements were assessed with Pearson product-moment correlation coefficients. Simple and multiple regression analyses showed significant correlations between stature and cranial measurements. In conclusion, cranial measurements obtained from 3D CT images may be useful for forensic estimation of the stature of Japanese individuals, particularly in cases where better predictors, such as long bones, are not available.     

CT and MRI of congenital sinonasal ossifying fibroma

We report a 9-year-old boy with a sinonasal ossifying fibroma, probably congenital, with atypical findings on CT and MRI. CT revealed a soft-tissue density mass in the sphenoethmoidal sinuses, nasal cavity and right maxillary sinus with a few foci of calcification and with remodelling and destruction of the adjacent facial bones. MRI showed high signal on T2- and intermediate signal on T1-weighted images. A thin, partly enhancing outer shell and some nonenhancing septa were visible on contrast-enhanced images. MRI also showed the tumour to extend into the anterior cranial fossa. Subtotal removal was performed. We compare our findings with reports in the literature and discuss the differences from fibrous dysplasia. Received: 30 September 1998 Accepted: 18 December 1998     

骨血管源性肿瘤的影像学诊断(附23例报告)

目的探讨骨血管源性肿瘤的影像学特点,旨在提高其诊断水平。方法对发生在不同部位的23例骨血管源性肿瘤的X线片、CT片和MRI片进行回顾性分析。结果19例骨血管瘤典型影像学表现根据其发生部位分为3种:椎体为栅栏状或网眼状;颅骨为放射状;长管状骨为多囊状或泡沫状。19例中术前误诊为骨纤维异常增殖症和骨巨细胞瘤各1例。4例骨血管肉瘤的影像学主要表现为溶骨性骨质破坏或骨质破坏与成骨增生混合存在。术前误诊为骨纤维异常增殖症及脊索瘤各1例和未定性2例。4例术后虽然进行放、化疗,但仍有2例在短期内发生肺及纵隔转移。结论典型骨血管瘤的影像学具有一定的特征性表现,结合临床资料,一般可做出诊断。而骨血管肉瘤的影像学表现无特征性。     

Fibrous dysplasia of the facial bones. A CT study

The authors report 7 cases of fibrous dysplasia of the facial bones which were evaluated with CT. The involvement of the facial bones by fibrous dysplasia is an uncommon event, which causes different syndromes according to the extent of bone invasion. In all the cases occurred to our observation CT allowed an exact spatial evaluation of the dysplasia, and therefore a correct surgical planning. Moreover, CT densitometric values and CT appearance of fibrous dysplasia often suggested the correct diagnosis.     

骨纤维异常增殖症的影像诊断

目的:探讨骨纤维异常增殖症的影像诊断方法及其价值。方法:搜集经手术病理证实的骨纤维异常增殖症34例,所有病例均行X线检查,其中加行CT 10例,MRI 2例,加行Gd-DTPA增强扫描1例。结果:单骨型27例,其中单骨单灶26例,单骨双灶1例;多骨型7例,其中单肢型2例,1例累及单侧5根肋骨和3节胸椎。X线平片和CT上表现为囊状改变22例,磨玻璃样改变8例,丝瓜络样改变3例,虫蚀样改变1例,合并病理骨折3例。结论:大多数骨纤维异常增殖症具有典型影像学表现,其检查方法仍以X线平片为主,观察复杂部位及病灶内改变以CT为优。低髓腔硬化征对诊断该病具有一定意义。