脊柱骨巨细胞瘤MSCT和3.0TMRI对比分析  

Compartive study of giant cell tumor in vertebral column with MSCT and 3.0T MRI

作　　者：牛富业[1,2] 王晨光[1] 马燕青[1] 张杰华[2] 徐才国[2] 尹雪军[2] 

机构地区：[1]第二军医大学附属上海长征医院影像科,上海200003 [2]解放军第413医院放射科

出　　处：《实用放射学杂志》2015年第1期110-112,120,共4页Journal of Practical Radiology

摘　　要：目的：分析脊柱骨巨细胞瘤（GCT）的 MSCT 和高场强 MRI 表现,提高本病的影像学诊断水平。方法对27例手术病理证实的脊柱 GCT MSCT 和3.0T MRI 资料进行回顾性分析。结果27例中,发生于颈椎4例、胸椎12例、腰椎5例、骶椎6例。影像学表现为偏心性、膨胀性骨质破坏。CT 呈软组织密度,内可见囊变、坏死,多可见骨棘残存,未见钙化及骨膜反应。MRI 多表现为 T1 WI 呈等、低信号,T2 WI 呈等、低或混杂高信号；合并动脉瘤样骨囊肿者表现为多囊状高信号,内可见液-液平面。结论脊柱 GCT 影像学表现具有一定的特征性,CT 和 MRI 结合分析,可以提高其术前诊断率,对临床分期、手术方案制订及术后评估具有重要价值。Objective To study the imaging features of spinal giant cell tumors （GCTs）including multi-slice spiral CT （MSCT） and MRI in order to improve the diagnosis.Methods A retrospective study was conducted in 27 patients with GCTs in the spine at our institute.The data of MSCT and 3.0T MRI were recorded and analyzed.Results Of the 27 patients,4 were found in the cervi-cal spine,12 in the thoracic spine,5 in the lumbar spine and 6 in the sacral spine.Typical imaging features showed eccentric,expan-sive and lytic bone destruction of the involved vertebra.The tumor showed soft-tissue density on CT with inner visible cystic change, necrosis and trabecula remnants in most tumors,without calcification and periosteal reaction.Most lesions showed hypointensity or isointensity on T1 WI and hypointensity,isointersity or heterogeneous high signal on T2 WI.When aneurysmal bone cyst （ABC）was detected,MRI revealed hyperintensity with a fluid-fluid interface.Conclusion Radiographic features of the GCTs in the spine are specific for diagnosis to some extent.CT and MRI may contribute to the accuracy of preoperative diagnosis.The methods have a good value in GCT diagnosis,clinical staging,surgical strategies and postoperative evaluation.

关 键 词：脊柱 骨巨细胞瘤 计算机体层成像 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]