脊柱骨巨细胞瘤影像学表现  

Imaging findings of spinal giant cell tumor

作　　者：高宇[1] 马晓晖[1] 张伟[1] 赵建[1] 李石玲[1] 赵振江[1] 刘杰[1] 宋岩[1] 蒋臻[1] 

机构地区：[1]河北医科大学第三医院放射科、CT室,河北石家庄050051

出　　处：《实用放射学杂志》2014年第7期1165-1168,共4页Journal of Practical Radiology

摘　　要：目的：总结脊柱骨巨细胞瘤影像学特点,提高诊断和鉴别诊断水平。方法经病理证实的28例脊柱骨巨细胞瘤,其中颈椎2例,胸椎8例,腰椎8例,骶椎10例。所有病例均行 X 线、CT 和 MRI 检查。结果（1）脊柱骨巨细胞瘤骶椎发生率最高可达35.7%。病变可侵犯单一或多个椎体,骶椎病变均侵犯多椎体。（2）X 线平片及 CT 可见椎体呈中心性或偏心性骨质破坏,22例病变波及附件骨,21例病变内有骨嵴或骨性间隔,26例伴有软组织肿物。（3）MRI 扫描显示病变 T1 WI 呈不均匀的等或稍低强度信号,T2 WI 呈不均匀高或等强度信号,STIR 呈不均匀高或稍高密度信号。（4）术后复发病变区再次出现膨胀性骨质破坏和软组织肿物。结论 X 线平片、CT 与 MRI 影像对脊柱骨巨细胞瘤诊断具有重要价值,三者结合有助于提高诊断及鉴别诊断准确性。Objective To improve the accuracy of diagnosis and differential diagnosis by summarizing imaging characteristics of spinal giant cell tumor of bone （GCTB）.Methods Total 28 cases of spinal GCT were confirmed by pathology,of which 2 localized in cervical vertebra,8 in thoracic vertebra,8 in lumbar vertebra,and the other 10 lesions in the sacrum.All patients underwent X-ray,CT,and MRI scanning.Results （1）The incidence of spinal GCTB in the sacrum is highest,up to 35.7%.Lesions can locate in single or more vertebral bodies.All of the 10 cases with primary lesion locating the sacrum were involved in more vertebral bodies. （2）X-ray and CT showed central or eccentric vertebral destruction with 22 cases involving in adnexal bones,21 cases with bone crest or bony septum and 26 cases with soft tissue mass.（3）Lesions examined with MRI showed inhomogeneous isointense or slight hy-pointense on T1 WI,inhomogeneous hyperintense or isointense on T2 WI and inhomogeneous hyperintense or slight hyperintense on STIR.（4）Expansive bone destruction and soft tissue mass occurred again in postoperative recurrent lesions.Conclusion X-ray,CT and MRI are of significant value in the diagnosis of the spinal GCT.The combination of the three is helpful to improve the accuracy of diagnosis and differential diagnosis.

关 键 词：脊柱 巨细胞瘤 影像学特点 

分 类 号：R738.1[医药卫生—肿瘤] R814.4[医药卫生—临床医学]