Yuan Xiao-ping, Xie Bang-kun, Lin Xiao-feng, Liang Bi-ling, Zhang Fan, Li Jie-ting
Department of Radiology, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2008 Aug;28(9):1700-2, 1706.
To assess the value of multi-slice spiral CT (MSCT) with three dimensional (3D) reconstruction in the diagnosis of neoplastic lesions in the jawbones.
Thirty-three patients with neoplastic lesions of the jawbones underwent MSCT scanning with 3D reconstruction. Of these patients, 14 had ameloblastoma, 8 had hemangioma, 3 had osteosarcoma, 3 had ossifying fibroma, 2 had chondrosarcoma, 2 had fibrosarcoma, and 1 had odontogenic myxoma. Preoperative MSCT scanning was performed with the slice thickness of 2 mm, and 3D reconstruction of the images was conducted by means of multi-planar reconstruction (MPR), curved-planar reformation (CRP), and 3D volume rendering technique (VRT). The results were compared with those observed during the operations.
In the 33 cases, the neoplastic lesions of the jawbones were displayed by 2D or 3D imaging and confirmed by intraoperative findings. Two-dimensional imaging allowed better observation than 3D imaging of the deep structures, whereas 3D imaging was superior in visualizing the morphological changes of the compromised bones and the spatial relationship between the tumors and surrounding structures. Two-dimensional imaging and MPR were excellent in revealing the internal structures and pathological changes of tumors, having also better performance in showing the tumors involving the soft tissues. Benign tumors were most visualized as bone expansion changes with well defined ovoid or lobulated borderlines, and malignant ones often resulted in adjacent bony destruction and soft tissue masses.
MSCT examination is useful in defining the scope of tumor involvement and bony changes to help in the definite diagnosis, differential diagnosis and choice of clinical treatment. Two-dimensional imaging, MPR, VRT and CRP have their respective advantages and limitations in showing jawbone tumor, and their combination can be of great clinical value.
评估多层螺旋CT(MSCT)三维(3D)重建在颌骨肿瘤性病变诊断中的价值。
33例颌骨肿瘤性病变患者接受了MSCT扫描及3D重建。其中,成釉细胞瘤14例,血管瘤8例,骨肉瘤3例,骨化性纤维瘤3例,软骨肉瘤2例,纤维肉瘤2例,牙源性黏液瘤1例。术前进行MSCT扫描,层厚2mm,并通过多平面重建(MPR)、曲面重建(CRP)及3D容积再现技术(VRT)对图像进行3D重建。将结果与术中所见进行比较。
33例中,颌骨肿瘤性病变通过二维或三维成像显示,并经术中发现证实。二维成像在观察深部结构方面比三维成像更好,而三维成像在显示受累骨骼的形态变化以及肿瘤与周围结构的空间关系方面更具优势。二维成像和MPR在显示肿瘤内部结构和病理变化方面表现出色,在显示累及软组织的肿瘤方面也表现更佳。良性肿瘤多表现为骨质膨胀改变,边界清晰呈椭圆形或分叶状,恶性肿瘤常导致相邻骨质破坏及软组织肿块。
MSCT检查有助于明确肿瘤累及范围及骨质改变,以辅助明确诊断、鉴别诊断及选择临床治疗方案。二维成像、MPR、VRT和CRP在显示颌骨肿瘤方面各有优缺点,联合应用具有重要临床价值。