手足骨巨细胞瘤影像学征象分析  

Analysis of imaging signs of giant cell tumor of hand and foot bones

作　　者：段亚青 张秋娟[1] 张博[1] 毛翠平[1] 张楠[3] DUAN Yaqing;ZHANG Qiujuan;ZHANG Bo;MAO Cuiping;ZHANG Nan(Department of Medical Imaging,the Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China;Department of Radiology,Honghui Hospital,Xi’an Jiaotong University,Xi’an 710054,China;Department of Pathology,Honghui Hospital,Xi’an Jiaotong University,Xi’an 710054,China)

机构地区：[1]西安交通大学第二附属医院医学影像科,陕西西安710004 [2]西安交通大学附属红会医院影像科,陕西西安710054 [3]西安交通大学附属红会医院病理科,陕西西安710054

出　　处：《实用放射学杂志》2024年第4期613-616,共4页Journal of Practical Radiology

摘　　要：目的探讨手足骨巨细胞瘤(GCT)的影像学征象特点。方法回顾性分析18例经病理确诊的手足骨GCT的临床及X线、CT、MRI影像资料,并与54例长骨GCT影像学表现进行比较。结果18例手足骨GCT中手部8例,足部10例,其中短管状骨12例,足跗骨6例。所有病灶均为累及关节面的膨胀性溶骨性骨破坏,其中短管状骨GCT呈中心性生长,肿瘤占据骨的整个宽径,病变范围较长,与骨长轴一致,易侵及周围软组织,硬化边、骨嵴、分叶及骨膜反应少见,术后易复发。足跗骨与短管状骨GCT是否呈偏心性生长有统计学差异(P<0.05)。长骨GCT发生病理性骨折的概率明显大于短管状骨。2组病变在膨胀性生长、是否累及骨端、骨皮质筛孔征等方面差异无统计学意义。结论与长骨GCT相比,手足骨是GCT的罕见发生部位,侵袭性比长骨GCT更强,术后易复发,应充分注意其影像学特点,为临床制订治疗策略提供更准确的影像信息。Objective To investigate the characteristics of imaging signs of giant cell tumor(GCT)of the hand and foot bones.Methods The clinical,X-ray,CT and MRI images of 18 cases of GCT of hand and foot bones diagnosed by pathology were analyzed retrospectively.And compared with 54 cases of long bone GCT imaging manifestations.Results Among the 18 GCT cases of hand and foot bones,there were 8 cases of hand,10 cases of foot,including 12 cases of short tubular bone and 6 cases of tarsal bone.All lesions were dilatant osteolytic bone destruction involving the joint surface,in which the short tubular bone GCT showed central growth,the tumor occupied the entire wide diameter of the bone,the lesion range was long,consistent with the bone axis,easy to invade the surrounding soft tissue,sclerotic edge,bone ridge,lobed and periosteal reaction were rare,and prone to recurrence after surgery.The GCT of tarsal bone and short tubular bone showed eccentric growth,and there was statistical difference(P<0.05).The probability of pathological fracture in GCT of long bone was significantly greater than that of short tubular bone.There was no significant difference between the two groups in swelling growth,involvement of bone end and ethmoid sign of bone cortex.Conclusion Compared with long bone GCT,hand and foot bones are rare occurrence site of GCT,which is more aggressive than long bone GCT and prone to recurrence after surgery.Full attention should be paid to its imaging characteristics to provide more accurate image information for clinical treatment strategies.

关 键 词：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] R445.2