骨巨细胞瘤常见和典型的MRI表现分析

The Analysis of Common MRI Signs and Typical Cases of Bone Gant Cell Tumor

目的探讨骨巨细胞瘤（GCT）常见和典型的MRI表现，以提高对该病诊断和鉴别诊断的能力。资料与方法回顾性分析96例经手术病理证实为GCT患者的临床与MRI表现，将60％病例拥有的表现定义为常见表现，拥有所有常见表现的病例为典型病例。结果病变位于长管骨骨端63例，占65．63％；T1WI以中等信号为主夹杂低和／或高信号61例，占63．54％；T2WI以中等信号为主夹杂小片状高信号68例，占70．83％；病变内有液化、坏死69例，占71．88％；病变内无液-液面84例，占87．50％；病变达关节面或椎体终板者87例，占90．63％；病变邻近关节内无积液者75例，占78．13％；无软组织肿块者58例，占60．42％；病变边缘均有环形或不全环形的低信号带96例，占100％；病变边缘有不同程度水肿61例，占63．54％；58例增强扫描中，显著性不均匀强化48例，占82．76％；同时具有上述表现的病例共10例，占10．41％。结论GCT常见的MRI表现为：病变发生于20～40岁患者的长骨骨端；T1WI和T2WI以中等信号为主；边缘常有环形的低信号带；常出现液化、坏死但出血和液面较少；病变邻近关节面但多无关节积液，多无软组织肿块形成、周围有不同程度的水肿、常呈显著的不均匀强化，典型病例少见。

Objective To analyze the common MRI signs and typical cases of bone giant cell tumors, in order to improve its diagnostic accuracy. Materials and Methods The MR findings of 96 cases with bone giant cell tumors proved pathologically were analyzed retrospectively. The common signs were defined as the signs appeared in 60% cases. The typical cases were the cases with all the common signs. Results The common signs included ： patient with 20 - 40 ages （66.67%）, in the end of tubular bone（67.71% ）, predominantly intermediate signal intensity with hypo and/or hyperintensity foci in T1 weighted image（63.54% ）, predominantly intermediate signal intensity with patchy hyperintensity signal foci in T2 weighted image （70.83 % ）, liquefy and necrosis （71.88 % ） , without fluid - fluid levels （87.50%）, without liquid in the adjacent joint （78.13%） , without soft tissue mass （60.42%）, extending to subchondral bone or terminal plate of vertebral body （90.63%）, with integrated or unintegrated hypointensity margin（ 10% ）, with different degree edema around the lesions（63.54% ）, diffuse inhomogenerous enhancement（82.76% ）. All the common signs were appeared at the same time in 10 cases （ 10.41% ）. Conclusion Patient with 20 - 40 ages, in the end of long tubular bone, predominantly intermediate signal in T1WI and T2WI, liquefy and necrosis, no fluid-fluid levels and soft tissue mass, no liquid in the adjacent joint, extending to subchondral bone, with hypointensity signal margin and edema, and diffuse inhomogenerous enhancement are the common MRI signs, typical cases are rare.