目的：探讨可动脊柱骨巨细胞瘤（GCT）常见及少见影像表现，以提高对此肿瘤的认识。方法：回顾62例手术病理确诊的可动脊柱GCT影像表现，分析总结其常见及少见表现。结果：62例GCT中主体位于椎体的48例（77.4%），主体位于附件的14例（22.60%）；肿瘤分别位于颈椎（21例）、颈胸椎(4例)、胸椎（25例）、腰椎（12例）；8例（12.9%）肿瘤连续累及3个椎体水平；34例呈膨胀性、溶骨性骨破坏，12例（19.35%）可见硬化边， 23例（37.1%）可见残存骨嵴，6例肿瘤边缘可见钙化或骨化，8例肿瘤表现为椎旁巨大软组织肿块。T2WI呈等或低信号（34例），混杂信号（23 例）或高信号（3例），11例伴液-液平面形成。62例行CT及MRI增强检查，明显强化45例，占72.6%；中等及轻度强化的分别为6例和11例，分别占9.7%和17.7%；均匀强化的为23例，占37.1%。结论：可动脊柱GCT位于附件、累及多个椎体的少见；肿瘤周围硬化边及合并钙化骨化少见；表现为椎旁巨大软组织肿块，与骨破坏程度不成比例的少见；T2WI呈等低或混杂信号多见，表现为高信号的少见；GCT血供相对丰富，增强扫描中等或明显强化多见，轻度强化少见。
Abstract
Objective: To explore the usual and unusual imaging appearances of giant cell tumor(GCT) in the mobile spine so as to improve the understanding of GCT. Methods: Sixty-two patients with GCT of mobile spine confirmed by pathological examinations were retrospectively analyzed and imaging appearances were summarized. Results: Forty-eight cases(77.4%) were located in the vertebral body and 14 cases(22.60%) located in the attachment of vertebra among 62 cases. Tumors located in cervical(21 cases), cervical-thoracic(4 cases), thoracic(25 cases) and lumbar(12 cases) spine. Adjacent three vertebral body or attachments were involved in 8 cases(12.9%). Thirty-four cases showed swelling bone destruction, 12 cases(19.35%) of the visible hardening ring, 23 cases(37.1%) with remaining bone crest, 6 cases of tumor edge with calcification or ossification, 8 cases with a huge mass lesion formation. Thirty-four tumors showed iso-intensity or low signal intensity, 23 with heterogeneous signal intensity and 3 with hyperintensity on T2WI and 11 cases had liquid level formation. Forty-five cases showed obvious enhancement, accounting for 72.6%. Six and 11 cases showed moderate and mild enhancement, accounting for 9.7% and 17.7% respectively. Uniform enhancement was in 23 cases, which accounted for only 37.1% among 62 cases of CT and MRI enhancement examinations. Conclusion: It is rare for GCT in the mobile spine to be located in the attachments or involve multiple vertebral bodies. Sclerosis rim around the tumor or calcification ossification is rare. Disproportionate huge mass formation and bone damage is rare. T2WI mainly shows low or mixed signals and high signal is rare. Tumor blood supply is relatively abundant with medium or obvious enhancement and mild enhancement is rare.
关键词
骨肿瘤 /
巨细胞瘤 /
骨 /
脊柱 /
体层摄影术 /
螺旋计算机 /
磁共振成像
Key words
Bone neoplasms /
Giant cell tumor of bone /
Spine /
Tomography, spiral computed /
Magnetic resonance imaging
中图分类号：
Ｒ738.1
Ｒ730.262
R814.42
R445.2
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