|其他题名||The imaging diagnosis of spinal giant cell tumor with vertebral compression
|邢晓颖; 爱华; 夏木西日甫; 袁慧书
体层摄影术 ,X 线计算机
Giant cell tumor
Magnetic resonance imaging
|摘要||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。
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 .|
|作者单位||1.北京大学第三医院放射科 北京 100191|
2.新疆医科大学第一附属医院放射科 新疆 乌鲁木齐 830011
邢晓颖,爱华,夏木西日甫,等. 伴有压缩改变的脊椎骨巨细胞瘤影像学诊断[J]. 医学影像学杂志,2015(5):881-884.
邢晓颖,et al."伴有压缩改变的脊椎骨巨细胞瘤影像学诊断".医学影像学杂志 .5(2015):881-884.
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