CAJ | 학술논문

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。
목적：총결척주골거세포류영상학특점,제고진단화감별진단수평。방법경병리증실적28례척주골거세포류,기중경추2례,흉추8례,요추8례,저추10례。소유병례균행 X 선、CT 화 MRI 검사。결과(1)척주골거세포류저추발생솔최고가체35.7%。병변가침범단일혹다개추체,저추병변균침범다추체。(2)X 선평편급 CT 가견추체정중심성혹편심성골질파배,22례병변파급부건골,21례병변내유골척혹골성간격,26례반유연조직종물。(3)MRI 소묘현시병변 T1 WI 정불균균적등혹초저강도신호,T2 WI 정불균균고혹등강도신호,STIR 정불균균고혹초고밀도신호。(4)술후복발병변구재차출현팽창성골질파배화연조직종물。결론 X 선평편、CT 여 MRI 영상대척주골거세포류진단구유중요개치,삼자결합유조우제고진단급감별진단준학성。
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.