CAJ | 학술논문

目的：探讨伴有压缩改变的脊椎骨巨细胞瘤的影像学表现。方法回顾分析63例经穿刺或手术病理证实的伴有压缩改变的脊椎骨巨细胞瘤的 X 线、CT 及 MRI 表现。结果63例中43例伴有压缩改变（68．3％），共计43个病灶，均表现为溶骨性骨质破坏。局限于单一椎体病灶34个（79．1％），累及邻近椎体病灶9个（20．9％）。按椎体压缩程度分为轻、中、重三组。轻度压缩组24例，95．8％的病灶呈明显膨胀性改变，87．5％的病灶可见残存骨嵴；中度压缩组7例，85．7％的病灶呈轻度膨胀性改变，所有病灶（100％）均可见残存骨嵴；重度压缩组12例，67．7％的病灶可见膨胀性改变，33．3％的病灶可见残存骨嵴。轻中度压缩组以椎体膨胀性改变为主，重度压缩以附件膨胀性改变为主。各组间膨胀性改变无明显统计学差异（ P ＞0．05），而骨嵴及椎旁软组织肿块出现的几率各组间差异有统计学意义（ P ＜0．05）。 MRI 表现为肿瘤实性成分在 T1 WI 呈低‐等信号，T2 WI 呈等信号，46．9％可见囊变，18．8％可见液‐液平面。结论脊柱骨巨细胞瘤在椎体轻度或中度压缩时椎体膨胀性改变及骨嵴较明显；在椎体明显压缩时附件膨胀性改变结合椎旁软组织肿块MR 信号特点有助于诊断。
목적：탐토반유압축개변적척추골거세포류적영상학표현。방법회고분석63례경천자혹수술병리증실적반유압축개변적척추골거세포류적 X 선、CT 급 MRI 표현。결과63례중43례반유압축개변（68．3％），공계43개병조，균표현위용골성골질파배。국한우단일추체병조34개（79．1％），루급린근추체병조9개（20．9％）。안추체압축정도분위경、중、중삼조。경도압축조24례，95．8％적병조정명현팽창성개변，87．5％적병조가견잔존골척；중도압축조7례，85．7％적병조정경도팽창성개변，소유병조（100％）균가견잔존골척；중도압축조12례，67．7％적병조가견팽창성개변，33．3％적병조가견잔존골척。경중도압축조이추체팽창성개변위주，중도압축이부건팽창성개변위주。각조간팽창성개변무명현통계학차이（ P ＞0．05），이골척급추방연조직종괴출현적궤솔각조간차이유통계학의의（ P ＜0．05）。 MRI 표현위종류실성성분재 T1 WI 정저‐등신호，T2 WI 정등신호，46．9％가견낭변，18．8％가견액‐액평면。결론척주골거세포류재추체경도혹중도압축시추체팽창성개변급골척교명현；재추체명현압축시부건팽창성개변결합추방연조직종괴MR 신호특점유조우진단。
Objective To summarize imaging findings of spinal giant cell tumor with vertebral compression .Methods The X‐ray ,CT and MRI manifestations of 63 cases of spinal giant cell tumor confirmed by biopsy or surgical pathology were analyzed retrospectively .Results 43(68 .3% ) of the 63 cases were with vertebral compression .All the 43 lesions were with osteolytic destruction .34 lesions (79 .1% ) involved single vertebral segment and 9 lesions (20 .9% ) involved the multiple .According to the degree of vertebral compression ,they were divided into mild ,moderate ,severe groups .In the mild group of 24 lesions ,95 .8% of lesions were involved in obvious expansion change ,and 87 .5% of lesions with re‐sidual bone trabeculae ;in the moderate group of 7 lesions ,85 .7% of the lesions were in mild expansion change and all le‐sions (100% ) with residual bone trabeculae ;in the severe group of 12 lesions ,67 .7% of lesions were in expansion change and only 33 .3% of lesions with residual bone trabeculae .The mild and moderate groups were mainly characterized by ex‐pansion change of vertebral body ,and the severe group was mainly characterized by posterior expansion change .Expansion change had no significant statistical differences between groups ( P > 0 .05) ,and the difference of the chances of residual bone trabeculae and paravertebral soft tissue mass between groups was statistically significant ( P < 0 .05) .MRI manifes‐tations showed low‐intermediate signal intensity on T1 WI and intermediate signal intensity on T2 WI of solid content , 46.9% with cystic change and partly visible fluid‐fluid levels (18 .8% ) .Conclusion The residual bone trabeculae and ex‐pansion change of vertebral body about giant cell tumor of spine in mild or moderate compression are obvious ;in obviously compressed vertebral bodies ,posterior expansion change by combining MR signal of paravertebral soft tissue mass can be helpful to the diagnosis .