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目的探讨儿童股骨肿瘤及肿瘤样病变的影像学表现。方法搜集59例经穿刺或手术病理证实的股骨肿瘤及肿瘤样病变的X线平片、CT和MRI检查资料,分析病变类型、部位、发病特点和影像学表现。57例行X线平片检查,37例行CT检查,25例行MRI检查。结果骨样骨瘤13例,骨肉瘤12例,骨软骨瘤8例,嗜酸性肉芽肿6例,软骨母细胞瘤5例,单纯性骨囊肿、动脉瘤样骨囊肿、非骨化性纤维瘤、骨纤维异常增殖症、血管瘤各2例,骨内腱鞘囊肿、韧带样纤维瘤、内生性软骨瘤、淋巴母细胞淋巴瘤、纤维性骨皮质缺损各1例。良性骨肿瘤32例(占54.2%),肿瘤样病变14例(占23.7%),原发恶性骨肿瘤13例(占22.0%)。结论儿童股骨骨病种类繁多,良性肿瘤以骨样骨瘤为好发病种,肿瘤样病变、恶性肿瘤分别以嗜酸性肉芽肿、骨肉瘤好发,多种影像学方法的联合使用在诊断和鉴别诊断中具有重要作用,有利于临床选择治疗方式及评判预后。
Objective To investigate the imaging features of femur and tumor-like lesions in children. Methods 59 cases of femoral tumor and tumor-like lesions confirmed by puncture or surgical pathology were collected and examined by X-ray, CT and MRI. The types, locations, onset characteristics and imaging findings were analyzed. 57 cases of X-ray examination, 37 cases of CT examination, 25 cases of MRI examination. Results There were 13 osteoid osteoma, 12 osteosarcoma, 8 osteochondroma, 6 eosinophilic granuloma, 5 chondroblastoma, simple cyst, aneurysmal bone cyst, non-ossifying fibroma , 1 case of fibrous dysplasia, 2 cases of hemangiomas, 1 case of intraosseous ganglion cyst, ligament-like fibroma, endochondromatosis, lymphoblastic lymphoma and fibrous cortical defect. 32 cases of benign bone tumors (54.2%), 14 cases of tumor-like lesions (23.7%), 13 cases of primary malignant bone tumors (22.0%). Conclusions There are many kinds of femoral osteodystrophy in children. Benign tumors are osteoid osteosarcoma with good incidence. Tumor-like lesions and malignant tumors are caused by eosinophilic granuloma and osteosarcoma, respectively. A combination of multiple imaging methods is used in the diagnosis and differential diagnosis Diagnosis plays an important role in the clinical choice of treatment and prognosis.