Mast H L, Haller J O, Solomon M
Department of Radiology, State University of New York, Health Science Center, Brooklyn 11203.
Comput Med Imaging Graph. 1992 Jan-Feb;16(1):1-9. doi: 10.1016/0895-6111(92)90193-d.
The CT criteria for classifying lesions of the mandibular and maxillary regions in adults as benign or malignant are well recognized: irregular soft tissue margins and bone destruction. We reviewed the charts of 12 pediatric patients from 3 institutions to evaluate these criteria in children. These masses were evaluated by CT and/or MRI based solely on well-recognized and published criteria. The patients' ages ranged from 4 mo to 18 yr. The histological diagnoses were ameloblastoma (4), hemangioma (2), lymphangioma, desmoplastic fibroma, hemangiopericytoma, neurofibroma, fibrous dysplasia, and juvenile angiofibroma. All but one case was surgically proven. Among the 12 cases, 5 had bone destruction and 5 showed irregular soft tissue margins. Three cases satisfied both criteria. With well-recognized CT criteria (in adult patients), characterization of these processes led to an incorrect diagnosis of a malignant lesion in 8 of the 12 cases preoperatively. Therefore, CT and MR imaging should only be a guide to the planning and extent of surgical resection. Without clearly defined distal spread of the mass, the classification of these masses in children should be made with caution.
将成人下颌和上颌区域病变分类为良性或恶性的CT标准已得到广泛认可：软组织边缘不规则和骨质破坏。我们回顾了来自3家机构的12例儿科患者的病历，以评估儿童中的这些标准。这些肿块仅根据公认且已发表的标准通过CT和/或MRI进行评估。患者年龄从4个月到18岁不等。组织学诊断为成釉细胞瘤（4例）、血管瘤（2例）、淋巴管瘤、促纤维增生性纤维瘤、血管外皮细胞瘤、神经纤维瘤、骨纤维异常增殖症和青少年血管纤维瘤。除1例病例外，其余均经手术证实。在这12例病例中，5例有骨质破坏，5例显示软组织边缘不规则。3例符合这两个标准。根据公认的CT标准（在成年患者中），对这些病变的特征描述导致术前12例病例中有8例被误诊为恶性病变。因此，CT和磁共振成像仅应作为手术切除计划和范围的指导。在肿块远端扩散未明确界定的情况下，对儿童这些肿块的分类应谨慎进行。
