骶骨骨巨细胞瘤X线、CT及MRI表现  

X-ray,CT and MRI Findings of Giant Cell Tumor of Bone in Sacrum

作　　者：白荣杰[1] 张卉[1] 程克斌[1] 于爱红[1] 王予生[1] 程晓光[1] 顾翔[1] 屈辉[1] 

机构地区：[1]北京积水潭医院放射科,北京100035

出　　处：《临床放射学杂志》2011年第7期1035-1038,共4页Journal of Clinical Radiology

摘　　要：目的分析骶骨骨巨细胞瘤(GCT)的X线、CT和MRI表现特点,探讨三种影像检查方法的临床应用价值。资料与方法 21例骶骨GCT均经手术病理证实,所有病例均行X线、CT和MRI检查,分析骶骨GCT的X线平片、CT、MRI表现特点,将影像学表现与手术病理结果进行对照,并经双盲法分析确认。结果 21例中,X线和CT显示囊性膨胀性骨质破坏18例,溶骨性骨质破坏15例,骨包壳不完整14例,MRI显示骨质破坏10例。X线显示侵犯骶髂关节及髂骨5例,CT显示16例,MRI显示11例。CT平扫显示软组织肿块12例,CT增强显示16例,MRI显示16例,其中巨大囊实性软组织肿块12例,10例可见液平面,病灶周围可见软组织水肿及骨髓水肿。骨质破坏在MR SE T1WI上呈等低信号,T2WI呈等信号。骨包壳在MRI上表现为低信号,X线和CT上表现为硬化环。软组织肿块实性部分在T1WI为等信号,T2WI及短时反转恢复(STIR)呈等高信号。囊性部分在T1WI为低信号,T2WI及STIR呈等高信号。软组织水肿及骨髓水肿在T2WI及STIR呈高信号。CT和MRI增强软组织肿块实性部分明显强化,囊性部分不强化。结论 X线、CT和MRI从不同方面反映骶骨GCT的病理改变,三种检查方法的结合可更全面显示骶骨GCT的影像学特点,有利于定性和鉴别诊断。Objective To study the X-ray,CT and MRI features of giant cell tumor of bone in sacrum and to evaluate their clinical value.Materials and Methods 21 cases of giant cell tumor of bone in sacrum were proved by surgery and pathology.All of the patients were examined by X-ray,CT and MRI.The imaging manifestations including X-ray,CT and MRI were analyzed,and the relationship of the imaging features with the pathological types of giant cell tumor of bone in sacrum was also observed.The imaging features were compared with the pathologic findings and confirmed with double blind method.Results Of the 21 cases,there were 18 cases with cystic expansion of bone destruction,15 cases with osteolytic bone destruction and 14 cases with incomplete shell of bone on X-ray and CT.There were 10 cases with bone destruction on MRI,and 5 cases violation of the sacroiliac joints and ilium on X-ray,and 16 cases with violation of the sacroiliac joints and ilium on CT.There were 11 case with violation of the sacroiliac joints and ilium on MRI.There were 12 cases and 16 cases with soft tissue mass on plain scan and after the injection of contrast medium on CT,respectively.There were 16 cases with soft tumor and 12 cases with a huge cystic soft tissue mass,and 10 cases with fluid level on MRI.Soft tissue edema and bone marrow edema can be seen around the lesion on MRI.Bone destruction showed iso-and hypo-intense on T1WI and iso-signals on T2WI.The shell of bone were hypointense on both T1WI and T2WI and showed hyperdensity on CT.The solid portions of soft tissue mass showed iso-signals on T1WI and iso-hyperintense signals on T2WI or STIR.The soft tumor of cystic part showed hypo-intense signals on T1WI and iso-hyperintense signals on T2WI or STIR.The soft tissue edema and bone marrow showed hyperintense signals on T2WI and STIR.There was enhancement in areas of soft tissue with solid part and no enhancement in cystic part of soft tissue on CT and MRI.Conclusion The X-ray,CT and MRI can reflect the pathological changes of giant cell tumor of b

关 键 词：骶骨 骨巨细胞瘤 磁共振成像 体层摄影术 X线计算机 放射摄影术 

分 类 号：R738.1[医药卫生—肿瘤]