骶尾部骨巨细胞瘤和脊索瘤影像学鉴别诊断  

DIFFERENTIAL DIAGNOSIS OF GIANT-CELL TUMOR OF BONE AND CHORDOMA IN THE SACROCOCCYGEAL REGION BASED ON IMAGING EXAMINATION

作　　者：张静[1] 崔久法[1] 高传平[1] 刘桢 和福 徐文坚[1] ZHANG Jing;CUI Jiufa;GAO Chuanping;LIU Zhen;HE Fu;XU Wenjian(Department of Radiology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院放射科

出　　处：《青岛大学学报（医学版）》2019年第5期518-522,共5页Journal of Qingdao University(Medical Sciences)

摘　　要：目的 比较骶尾部骨巨细胞瘤和脊索瘤影像学表现差异,提高对这两种肿瘤的鉴别诊断水平。方法收集经手术病理证实的骶尾部骨巨细胞瘤11例和脊索瘤18例,其中10例骨巨细胞瘤和15例脊索瘤病人行CT检查,9例骨巨细胞瘤和13例脊索瘤病人行MRI检查。对两种肿瘤的影像学表现进行回顾性分析。结果 骨巨细胞瘤病人的年龄低于脊索瘤病人,差异有统计学意义(χ^2=17.923,P<0.05)。骨巨细胞瘤位于S1~S3者10例、位于S3以下者1例,脊索瘤全部位于S3以下,两者差异有统计学意义(χ^2=24.976,P<0.05)。骨巨细胞瘤10例呈膨胀性骨质破坏、1例呈溶骨性骨质破坏,脊索瘤均呈溶骨性骨质破坏,两者差异有统计学意义(χ^2=24.976,P<0.05)。骨巨细胞瘤6例在椎管外形成软组织包块,脊索瘤全部在椎管外形成软组织包块,两者差异有统计学意义(χ^2=9.886,P<0.05)。骨巨细胞瘤9例累及单椎体、2例累及多椎体,脊索瘤全部累及多椎体,两者差异有统计学意义(χ^2=21.355,P<0.05)。骨巨细胞瘤8例累及椎间隙,脊索瘤5例累及椎间隙,两者差异有统计学意义(χ^2=5.578,P<0.05)。行CT检查的10例骨巨细胞瘤中1例骨性包壳不完整,15例脊索瘤骨性包壳均不完整,两者差异有统计学意义(χ^2=21.094,P<0.05)。结论 骶尾部骨巨细胞瘤和脊索瘤在发病年龄、发病部位、肿瘤的生长方式、椎旁有无软组织包块、病变累及椎体、病变是否累及椎间隙、骨壳的完整性方面存在差异,这有助于两者的鉴别诊断。Objective To compare the imaging findings of giant-cell tumor of bone and chordoma in the sacrococcygeal region, and to improve the differential diagnosis of these two tumors. Methods A total of 11 patients with pathologically confirmed giant-cell tumor of bone and 18 patients with pathologically confirmed chordoma were enrolled;10 patients with giant-cell tumor of bone and 15 with chordoma underwent CT, and 9 patients with giant-cell tumor of bone and 13 with chordoma underwent MRI. A retrospective analysis was performed for the imaging findings of these two tumors. Results The patients with giant-cell tumor of bone had a significantly younger age than those with chordoma (χ^2=17.923, P <0.05). Among the 11 patients with giant-cell tumor of bone, 10 had the tumor located in the S 1-S 3 area and 1 had the tumor located below the S 3 area, while all patients with chordoma had the tumor located below the S 3 area, and there was a significant difference between the two groups of patients (χ^2=24.976, P <0.05). Among the 11 patients with giant-cell tumor of bone, 10 had expansive bone destruction and 1 had osteolytic bone destruction, while all patients with chordoma had osteolytic bone destruction, and there was a significant difference between the two groups of patients (χ^2=24.976, P <0.05). Among the 11 patients with giant-cell tumor of bone, 6 had the formation of soft tissue masses outside the spinal canal, while all patients with chordoma had the formation of soft tissue masses outside the spinal canal, and there was a significant difference between the two groups of patient (χ^2=9.886, P <0.05). Among the 11 patients with giant-cell tumor of bone, 9 had the involvement of a single vertebral body and 2 had the involvement of multiple vertebral bodies, while all patients with chordoma the involvement of multiple vertebral bodies, and there was a significant difference between the two groups of patient (χ^2=21.355, P <0.05). Among the 11 patients with giant-cell tumor of bone, 8 had the involvement of the i

关 键 词：骨巨细胞瘤 脊索瘤 骶尾部 体层摄影术 X线计算机 磁共振成像 诊断 鉴别 

分 类 号：R445[医药卫生—影像医学与核医学] R738.1[医药卫生—诊断学]