胸腰椎骨巨细胞瘤与孤立性浆细胞瘤的CT与MRI表现比较  

Comparisons of CT and MRI Findings of Giant Cell Tumors and Solitary Plasmacytomas of Thoracolumbar Spine

作　　者：张勇[1] 李颖文[1] 杨晓[1] 王梓旭[1] ZHANG Yong;LI Ying-wen;YANG Xiao;WANG Zi-xu(Department of Radiology,the Second People's Hospital of Yunnan Province,Kunming 650021,Yunnan Province,China)

机构地区：[1]云南省第二人民医院放射科,云南昆明650021

出　　处：《中国CT和MRI杂志》2021年第6期163-166,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨比较胸腰椎骨巨细胞瘤与孤立性浆细胞瘤的CT与MRI临床表现。方法选取我院自2017年10月至2018年10月收治的胸腰椎骨巨细胞瘤与孤立性浆细胞瘤患者各20例为研究对象,均经病理证实,统计分析所有患者临床一般资料与术前影像资料,并探讨针对其应用CT与MRI检查的临床表现。结果分析研究数据显示,CT、MRI对骨巨细胞瘤于孤立性浆细胞瘤发病部位检测结果差异不明显,无统计学意义(P>0.05)。胸腰椎骨巨细胞瘤CT扫描显示呈相对均匀软组织密度,各级肿瘤间无明显密度差异,且患者无骨膜反应,骨质破坏边缘清晰,无钙化。MRI表现为患者长骨骨端偏心性膨胀性破坏达关节面下,伴有坏死囊变,增强扫描有不均匀强化及信号不均匀情况,且边缘可见低信号环,周围伴有骨髓水肿。孤立性浆细胞瘤CT扫描显示患者病灶区域表现为溶骨样与虫蚀样骨质破坏,破坏区边界清晰,有硬化边,骨嵴上下径稍长,横断位粗短;且骨质破坏区呈现出软组织密度影填充,内部密度均匀,无坏死或囊变征象。MRI检测病灶信号不一,4例患者中T1WI呈现出低或等低信号,T2WI呈现出高信号或是混杂高信号,而压脂序列则表现出明显高信号;6例患者软组织肿块明显,均匀强化,骨质破坏区域周围无骨髓水肿信号。结论针对胸腰椎骨巨细胞瘤与孤立性浆细胞瘤患者在临床诊断中可应用CT、MRI检查方式,其影像表现具备一定特征性,对明确肿瘤发生部位与周围组织情况有着积极参考价值,可将之用于临床辅助检查,提高诊断水平。Objective To compare the clinical manifestations of giant cell tumor of the thoracolumbar spine and solitary plasmacytoma on CT and MRI.Methods Twenty patients with giant cell tumors of the thoracolumbar spine and 20 patients with solitary plasmacytoma admitted to our hospital from October 2017 to October 2018 were selected for the study.All patients were confirmed by pathology.The clinical data and preoperative imaging data of all patients were analyzed statistically,and the clinical manifestations of CT and MRI examination were discussed.Results Analytical data showed no significant difference in the detection results of giant cell tumor of bone at the site of solitary plasmacytoma by CT and MRI(P>0.05).CT scan of giant cell tumors of the thoracolumbar spine showed relatively uniform soft tissue density.There was no significant difference in density between tumors at all levels.There was no periosteal reaction,a clear margin of bone destruction,and no calcification.MR imaging showed eccentric expansive destruction of the long bone tip,subarticular with necrotic cystic degeneration,uneven enhancement,and signal heterogeneity in contrastenhanced sca n ning,and the low signal ring could be seen at the edge,accompanied by bone marrow edema.CT scan of solitary plasmacytoma showed osteolytic and insect-like bone destruction in the lesion area,with clear boundary,sclerotic edge,slightly longer upper and lower bone ridge diameter,and short tra nsverse position;and the bone destruction a rea showed soft tissue density filling,uniform internal density,no signs of necrosis or cystic degeneration.In 4 patients,T1 W1 showed low or iso-low signal,T2 W1 showed high signal or mixed high signal,while lipid pressure sequence showed obvious high signal;6 patients had obvious soft tissue mass,homogeneous enhancement,and no bone marrow edema signal around bone destruction area.Conclusion CT and MRI can be used in the clinical diagnosis of giant cell tumors and solitary plasmacytomas of the thoracolumbar spine.The imaging manifestat

关 键 词：胸腰椎 骨巨细胞瘤 孤立性浆细胞瘤 CT MRI 

分 类 号：R323.3[医药卫生—人体解剖和组织胚胎学] R445.3[医药卫生—基础医学]