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牙源性角化囊肿(Odontogenic keratocyst)CT病例分析

时间:2010-11-08  来源:ACR Monday, May 18, 2009  作者:freemanpyw译 【复制分享】【讨论-纠错】【举报

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【讨论】:Odontogenic keratocysts also known as primordial cysts arises from remnants of dental lamina and make up 10% of jaw cysts. They occur more commonly in the 2nd to 4th decades and have a 2:1 M:F predilection.牙源性角化囊肿又被称为始基囊肿,起源于牙板的残留,占颌囊肿的10%,通常见于20-40岁,男女比约2:1W4X影像园cn-diwater.com

    75% are located in the posterior mandible around the 3rd molar. The most common maxillary location is the canine region. 50% are lucent, unilocular with well-defined sclerotic margins. Many cysts are expansile and multilocular.75%位于下颌骨后部环绕第三磨牙,上颌骨最常见于犬齿区,50%的表现为单房囊状,有边界清楚的硬化缘。一些囊肿可以是膨胀性的和多房状W4X影像园cn-diwater.com

    The pathology demonstrates remnants of dental lamina. They are comprised of a fibrous wall lined by squamous epithelium with a low protein content. The cysts could have a low attenuation on CT likely due to low protein content or a high attenuation from hemorrhage. Theses cysts make up 10% of jaw cysts and are associated with Noonan and Marfan syndrome. A minority of odontogenic keratocysts are multiple and 50% of these cases will have associated basal cell nevus. 病理学上证实为牙板的残留,包含有覆以鳞状上皮的纤维壁,伴有低蛋白含量。依据其内的低蛋白成分或出血,囊肿在CT上可以表现为低密度或高密度,这些囊肿占颌囊肿的10%,并且常伴有Noonan氏和Marfan氏综合症。少数的牙源性角化囊肿是多发性,并且这些病例的50%合并有基底细胞痣综合症。W4X影像园cn-diwater.com

    Approximately 50% of patients are symptomatic with jaw swelling being the most common symptom, seen in up to 85% of symptomatic patient. Other signs and symptoms include sinus tract with drainage seen in 15%, pain, paresthesia and trismus. 大约50%的患者有临床症状,颌部隆起是最常见的症状,见于85%以上的有症状的患者。其他的征像和症状包括窦道形成,疼痛,感觉异常以及牙关紧闭症。W4X影像园cn-diwater.com

    The natural history of odontogenic keratocysts are rapid growth with high recurrence rate. Treatment is with enucleation and aggressive curettage. Due to high recurrence rate follow up studies are recommended.牙源性胶质囊肿发展迅速,复发率高,治疗包括摘除术和大范围的刮除术,由于其复发率高,随访是必须的。W4X影像园cn-diwater.com

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