目的: 利用螺旋CT和锥束计算机体层摄影术(cone-beam computed tomography，CBCT)比较分析牙源性钙化囊肿(calcifying odontogenic cyst，COC)与牙源性钙化上皮瘤(calcifying epithelial odontogenic tumor，CEOT)的三维影像学特征。方法: 回顾性收集北京大学口腔医院经病理证实的19例COC和16例CEOT的螺旋CT或CBCT影像资料，结合患者的临床与病理表现分析其影像学特征，包括病变位置、大小、膨隆程度、内部结构及牙齿受累情况等，并对病变内钙化特点进行分类。结果: 19例COC患者中，男性12例，女性7例，平均年龄27岁，89.5%(17/19)的病变位于前牙区和前磨牙区，100.0%存在颌骨膨隆，78.9%出现骨皮质不连续。16例CEOT患者中，男性3例，女性13例，平均年龄36岁，81.3%(13/16)的病变位于前磨牙区和磨牙区，56.3%存在颌骨膨隆，93.8%出现骨皮质不连续。根据病变内钙化物的分布特点分为无钙化型(未见钙化影像)、边缘型(钙化影位于病变边缘，且仅在一侧散在分布)、弥散型(多发钙化影广泛分布于病变范围内)、团块型(存在直径大于5 mm的钙化团块)及冠周型(钙化影像聚集于阻生牙周围)。73.7%的COC病变区存在钙化，包括边缘型9例、弥散型3例及团块型2例；42.8%的CEOT病变区存在钙化，包括弥散型2例及冠周型5例。另外，6例COC病变中存在牙瘤样影像，9例无钙化的CEOT中8例为朗格汉斯(Langerhans)型，病变较小(近远中径平均为17.8 mm)，不含阻生牙，且无牙根吸收。结论: COC好发于颌骨前部，膨隆明显，而CEOT好发于颌骨后部，多存在骨皮质不连续。两者的钙化特点差异较大，COC病变区钙化影像发生率高，多沿病变边缘散在分布，位于病变一侧，远离阻生牙，部分病变与牙瘤共同发生；CEOT逾半数无钙化且病变较小，其余病变中钙化物影像多围绕在阻生牙周围。

Objective: To analyze the three-dimensional radiographic characteristics of calcifying odontogenic cyst and calcifying epithelial odontogenic tumor using spiral computed tomography (CT) and cone-beam computed tomography (CBCT). Methods: Clinical records, histopathological reports, and CBCT or non-enhanced spiral CT images of 19 consecutive patients with calcifying odontogenic cyst (COC) and 16 consecutive patients with calcifying epithelial odontogenic tumor (CEOT) were retrospectively acquired, and radiographic features, including location, size, expansion, internal structure and calcification, were analyzed. Results: Among the 19 COC cases (12 males and 7 females, with an average age of 27 years), 89.5% (17/19) of the lesions originated from the anterior and premolar areas, 100.0% of them exhibited cortex expansion, and 78.9% had discontinued cortex. Among the 16 CEOT cases (3 males and 13 females, with an average age of 36 years), 81.3% (13/16) of the lesions were in the premolar and molar areas, 56.3% of them exhibited cortex expansion, and 96.8% had discontinued cortex. According to the distribution of internal calcifications, these lesions were divided into: Ⅰ (non-calcification type): absence of calcification; Ⅱ (eccentric marginal type): multiple calcifications scattered along one side of the lesion; Ⅲ (diffused type): numerous calcifications diffusely distributed into the lesion; Ⅳ (plaque type): with a ≥ 5 mm calcified patch; Ⅴ (peri-coronal type): multiple calcifications clustered around impacted teeth. Calcifications were present in 73.7% of COC lesions, including 9 type Ⅱ, 3 type Ⅲ and 2 type Ⅳ lesions, and 42.8% of CEOT lesions had calcification images, including 2 type Ⅲ and 5 type Ⅴ lesions. Six COC lesions had odontoma-like images. Moreover, 8 of 9 type Ⅰ CEOTs were histologically Langerhans cell-rich subtype, which had a smaller size (with an average mesiodistal diameter of 17.8 mm) and were not associated with impacted teeth. Conclusion: COC lesions tended to originate from the anterior part of the jaw and exhibit cortex expansion, and were sometimes associated with odontoma. CEOT commonly occurred in the posterior jaw and had discontinued cortex. Two lesions had significantly different calcification map. Over 70% of COC lesions had calcification images, which were mostly scattered along one side of the cysts, far from the impacted teeth. Approximately 60% of CEOT lesions exhibited smaller size and non-calcification, and the remaining CEOT cases often had calcification images clustered around the impacted teeth.