骨樣骨瘤之放射線學評估

Radiological Evaluation of Osteoid Osteoma

張政彥(Cheng-Yen Chang) ； 詹益豐(Yick-Fung Jim) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 10卷4期 (1985/12) Pp. 295-300

摘要

骨樣骨瘤是一種良性的骨瘤，其主要組成有兩部份：(1)大約一公分橫徑或小一點的核心(nidus)，是真正的病灶位置，早期時呈低放射密度病灶(radiolucent)，沒有鈣化，但成熟時便可能見到鈣化的中心。(2)核心周邊反應性的骨硬化，骨皮質增厚及骨膜反應。自民國70年至73年我們覆閱了五位經過手術證實為骨樣骨瘤之病例及其放射線檢查；發現診斷的確立，除了特殊的病史外，可能需要常規攝影，斷層攝影，核子醫學掃描和電腦斷層攝影；其中大部份的病例皆可由斷層攝影示範出來，可是由於電腦斷層攝影具備了優良的橫切面解析影像條件，對於核心的偵測與定位非常之準確，所以由它讓外科醫師於手術前得到更詳細更有價值的診斷資料，而避免不適當的切除，手術的困難及病灶之復發。

並列摘要

Osteoid ostemoa is generally considered to be a benign tumor of bone. The actual lesion is 1 cm or less in size and is called the nidus. The nidus initially is uncalcified, but on maturity may develop calcification that may range from small flecks to calcification of its major portion. The second component of the lesion is reactive sclerosis with cortical thickening and periosteal reaction.
From 1981 to 1983, five surgically proved cases of osteoid osteoma were reveiwed, with emphasis on the modalities used in the detection, diagnosis and localization of this benign tumor. These included plain radiography, tomography, radionuclide imaging and computed tomography (CT). Diagnosis may require all of these techniques. Since CT is highly sensitive, and able to locate the lesion (nidus) in the transverse plane, it is superior than conventional tomography in the evaluation of these lesions and exact planning of surgery to avoid unnecessary large or misdirected resections.