骨盆骨巨细胞瘤影像特征分析

Analysis on the Imaging Features of Giant Cell Tumor of Bony Pelvis

目的:分析骨盆骨巨细胞瘤X线平片、CT及MRI征象,探讨其影像特征及鉴别诊断要点。方法:分析总结经手术及病理证实的29例(包括7例复发)骨盆骨巨细胞瘤患者的X线平片、CT、MRI表现。结果:①X线平片表现:囊状骨质破坏15例,单纯溶骨性破坏8例,"多房性"骨质破坏6例。②CT表现:18例呈囊样膨胀性骨质破坏,11例呈单纯溶骨性破坏,未见骨膨胀扩张征象;增强扫描肿瘤实质部分均出现轻度至中度的强化。③MRI表现:6例MRT1WI上均呈等信号、低信号,T2WI上呈低信号、等信号、高混杂信号。结论:骨盆巨细胞瘤的影学表现为膨胀性溶骨破坏,与长骨巨细胞瘤比较除膨胀更为显著外,余无明显差异;骨盆骨巨细胞瘤诊断需综合运用X线平片、CT及MRI并与临床表现相结合,且能够提高骨盆骨巨细胞瘤诊断及鉴别诊断的准确性。

Objective：To study the features of plain film,CT and MRI of giant cell tumor of bony pelvis and the differential diagnosis. Methods：The plain film,CT and MRI features of giant cell tumor of bony pelvis in 29 cases proved by surgery and pathology,including 7 recurrent cases, were reviewed. Results：On the plain films, cystic bony destruction was found in 15 cases （15/29）, single osteolytic destruction in 8 （8/29）, multilocular destruction of bones in 6 （6/29）. On CT, the cystic and expansive destruction of bones was shown in 18 （18/29）, single osteolytic destruction without signs of expansion in 11 （11/29）. There was low to middle increased attenuation in parenchymal part of tumors on enhancement scanning. On MRI, hypo- or iso-intensity on T1WI and hypo-,iso- or hyper-intensity on T2 WI were demonstrated in 6 （6/6）. Conclusion：Giant cell tumor of bony pelvis is of similar imaging feature to that in long bone except with more expansion. It is suggested to combine plain film, CT and MRI with clinical symptom for accurate diagnosis and differential diagnosis of giant cell tumor of pelvis bone.