患者，男，17岁，右下肢间歇性疼痛1个月，近1周以来疼痛加重，以夜间疼痛为著。
查体：右下肢远端略肿胀，压痛明显，皮肤表面颜色正常。
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上期试题：骨瘤的好发部位是A A．颅骨和颜面骨 B．长骨 C．短骨 D．椎骨 E．肋骨 患者，男，17岁，右下肢间歇性疼痛1个月，近1周以来疼痛加重，以夜间疼痛为著。 查体：右下肢远端略肿胀，压痛明显，皮肤表面颜色正常。 ↑CT平扫： 右胫骨远端骨皮质内见一类圆形骨质破坏区，病灶边界清楚，可见硬化环，相邻骨皮质明显增厚。 ↑矢状位T1WI抑脂像、矢状位T2WI抑脂像 ↑横轴位T2WI抑脂像、冠状位T2WI抑脂像 右胫骨远端骨皮质破坏区呈大片状长T1、长T2信号，T2WI抑脂像呈高信号，病灶中心明显低信号，相邻骨髓腔内可见大片状骨髓水肿，周围软组织肿胀。 骨样骨瘤是良性成骨性肿瘤，由成骨性结缔组织及其形成的骨样组织和编织骨所构成。本病多见于30岁以下的青少年，起病较缓，症状以疼痛为主，夜间加重，疼痛可局限于病变处，也可向肢体远端或周围扩散，疼痛可发生在X线征象出现之前。服用水杨酸类药物可缓解疼痛，为本病的特点。 Osteoid osteoma is a benign osteoid tumor composed of osteoconnective tissue and its formed bone tissue and braided bone. Onset of the disease among teenagers under the age of 30, slower, give priority to with pain symptoms, night is aggravating, the pain can be limited to the BingBianChu, can also be spread around to the distal limb or, pain can occur before the X-ray signs appear. Taking salicylic acid can relieve pain and is the characteristic of the disease. 骨样骨瘤可发生于任何骨骼，以胫骨和股骨多见，偶见于颅骨。肿瘤多发生于长管状骨骨干，多发生于骨皮质，其次为松质骨和骨膜下，少数发生于关节囊内骨。据受累部位大致可分为皮质型、松质型和骨膜下型，均表现为瘤巢所在部位的骨破坏区以及周围不同程度的反应性骨质硬化，可见瘤巢内的钙化或骨化影。 Osteoid osteoma can occur in any bone and is seen in the tibia and femoral bones, occasionally in the skull. The tumor was born in long tubular bone and was born in the bone cortex, followed by cancellous bone and subperiosteum, a few of which occurred in the sacs. According to the affected area can be roughly divided into cortex and cancellous and subperiosteal type, all show the tumor nests site bone destruction area and surrounding the reactivity of different level, bone sclerosis visible tumor calcification or ossification in the nest. 骨样骨瘤的影像学表现具有特征性，CT上其典型表现为骨皮质内直径小于2.0cm的类圆形透亮瘤巢，周围伴不同程度的骨质硬化，可伴有骨膜反应、周围软组织或邻近关节肿胀，而瘤巢位于松质骨、骨膜及复杂部位（如骨盆和脊柱等）者常无典型表现。 Imaging findings of osteoid osteoma has the characteristic, the typical performance for bone cortex on CT is less than 2.0 cm in diameter class round bright tumor nests, surrounding with different degrees of bone sclerosis, may be accompanied by periosteal reaction and soft tissue around or adjacent joint swelling, and tumor nests in cancellous bone, periosteum and complex parts (such as the pelvis and spine) is often not typical. MRI：肿瘤未钙化的部分在T1WI像上呈低到中等信号，T2WI像上呈高信号，钙化部分在T1WI和T2WI像上均呈低信号，肿瘤周围的骨松质和软组织呈大片状长T1、长T2信号；增强扫描后，肿瘤呈明显强化，瘤巢周围骨质硬化呈低信号，骨髓水肿区及周围软组织呈轻度强化。 Part of the MRI: without tumor calcification in a low to moderate signal on T1WI, like, a high signal on T2WI like, calcified part in are in low signal on T1WI and T2WI, cancellous bone and soft tissue around the tumor has big shape long T1, long T2 signal; After the enhancement of the scan, the tumor was significantly enhanced, and the bone sclerosis around the neoplasm showed low signal, and the bone marrow edema region and surrounding soft tissue were slightly enhanced. 本例患者为青少年，以小腿疼痛为主要症状，且有明显夜间疼痛，病灶发生于骨皮质，边缘可见明显骨质硬化，周围可见骨髓水肿，均提示骨样骨瘤的诊断，本例中，CT对瘤巢的显示优于MRI。 The patients for teenagers, leg pain as the main symptoms, and there is a clear night pain, lesions occurred in the bone cortex, the edge is obvious bone sclerosis, visible around the bone marrow edema, all suggest the diagnosis of osteoid osteoma, in this case, CT showed superior to MRI of tumor nests. 本期试题：水杨酸类药物可缓解疼痛的骨瘤是？ A.骨样肿瘤 B.软骨肿瘤 C.骨肉瘤 D.骨瘤 E.骨软骨瘤
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来自： zskyteacher > 《西航港之临床影像学习平台》
