颌骨病变种类较多，影像表现相互类似。本文总结62例颌骨肿瘤及肿瘤样病变的主要临床特征和CT 表现，以提高对常见颌骨病变的CT 诊断能力。1
资料与方法
1.1临床资料：
收集我院2010年1月至2017年9月行CT 扫描并经临床或病理证实的颌骨肿瘤及肿瘤样病变62例，回顾性分析其主要临床特征和CT
表现。
1.2方法：所有病例均行GE 双排螺旋CT （2013年
3月前病例）或GE Optima CT 660型64排螺旋CT 机平扫，管电压100~120kV ，管电流100~200mA ，层厚2.5~5mm ，螺旋扫描。骨窗：窗位350H u ，窗宽
2000H u ，软组织窗：窗位35H u ，窗宽350H u 。2名
高年资医师共同阅片，遇意见不一致，经讨论达成一致。2结
果
2.1
根尖囊肿：31例，
占50%，男性17例，女性14颌骨肿瘤及肿瘤样病变的CT 诊断
张喜旺谭继文张爱平韩文罡
【摘
要】目的分析颌骨肿瘤及肿瘤样病变的临床和CT 表现特征，提高鉴别诊断能力。方法回顾性
分析62例经临床或病理证实的颌骨肿瘤及肿瘤样病变的主要临床和CT 表现。结果颌骨囊肿性病变48例，其中根尖囊肿31例，囊肿多位于龋齿根尖，直径约1cm ；含牙囊肿14例，囊性病灶，膨胀性生长，轮廓光滑，其内可见畸形牙齿或正常牙冠；角化囊肿2例，多房性囊性病灶，沿下颌骨长轴生长；切牙管囊肿1例，位于上颌骨切牙管。良性肿瘤及肿瘤样病变13例，其中造釉细胞瘤11例，颌骨内类圆形或多分叶肿块，囊实性，颌骨皮质变薄，内缘多个切迹或断续，病灶内可见未长出的磨牙，邻近牙根切削、移位、脱失；骨纤维异常增生症1例，病变范围大，下颌骨体积增大，骨皮质完整，病灶呈毛玻璃样，与正常骨间无明显界限。骨化性纤维瘤1例，下颌骨内类圆形混杂密度肿块，其内可见斑片状骨质密度，骨皮质完整。骨肉瘤1例，下颌骨体部骨质破坏，骨皮质不完整，并颌骨内骨性密度肿块。结论结合年龄、病变部位、临床特征，CT 扫描能对颌骨肿瘤及肿瘤样病变作出初步
诊断，确诊需要病理检查。
【关键词】颅下颌骨病症；体层摄影术；诊断
DOI ：10.16106/14⁃1281/r.2019.01.006
作者单位：036002山西省朔州市朔城区人民医院CT 室
Diagnosis of tumors and tumor ⁃like diseases in the jaw by CT Zhang Xiwang,Tan Jiwen,Zhang Aiping,Han
Wengang.Department of CT ⁃Room,Shuochengqu People 忆s Hospital,Shanxi 036002,China
【Abstract 】Objective To analyze the clinic and CT imaging data about the jaw tumors and the tumor ⁃like dis ⁃eases in order to improve the ability of identifying these diseases.Methods The clinic and CT imaging data of 62cases with jaw tumors and the tumor ⁃like diseases were studied retrospectively.Results Forty ⁃eight cases were cyst.Respectively,apical cyst added up to 31cases,which was usually found to circle the root of decayed tooth,its diame ⁃ter was approximately 1.0cm.Dentigerous cysts of 14cases were counted,they expansively grew with smooth contour and there was often a dental crown or deformity tooth in them.Two cases were proved to keratocyst,they were multi ⁃locular and grew along long axis of the mandible.Only 1case was incisive canal cyst,it located in the incisive canal.Benign tumors and the tumor ⁃like diseases were 13cases.Eleven of them were ameloblastomas,they were often solid ⁃cystic,more lobular,occasionally there was an unerupted odontoprisis in the cyst,the border upon cortex of the jaw became thin,even broke,the invaded roots were truncated and shifted,even fell off.Fibrous dysplasia of bone and os ⁃sifying fibroma were each 1case.The former had wide range lesion with unclear boundary,the lesion looked like ground glass,the ill mandible increased in volume with whole bone cortex.While the latter was a quasi ⁃circular mass,which had inhomogeneous density with patchy bone density in it and whole bone cortex.Of all cases,one osteosarco ⁃ma was found,the mandible was destroyed while tumor bone was found in lesion.Conclusion To combine age of patient,position of lesion and clinical characteristic,the jaw tumors and the tumor ⁃like diseases may be tentatively di ⁃agnosed by CT imaging,the final diagnosis for them need examine by pathology.
【Key words 】Craniomandibular disorders;Computed tomography;Diagnosis
