骨盆骨巨细胞瘤X线、CT及MRI表现

Manifestations of giant cell tumor of bone in the pelvis on x-ray,CT and MRI

目的结合病理总结骨盆骨巨细胞瘤影像学特点及鉴别诊断要点。方法 32例骨盆骨巨细胞瘤患者均经手术与病理证实,其中骶骨18例,髂骨6例,耻骨4例,坐骨4例。所有病例均行X线、CT和MRI检查,将影像学表现与手术病理结果进行对照,并由双盲法分析确认。结果骨盆骨巨细胞瘤影像学表现包括膨胀性骨质破坏、溶骨性骨质破坏和软组织肿块。32例中,膨胀性病变26例,溶骨性骨质破坏6例,软组织肿块18例。CT显示骨质破坏优于X线平片,MRI可清晰显示肿瘤周围的软组织肿块和神经血管侵犯情况。结论综合临床表现与X线平片、CT、MRI检查资料可提高骨巨细胞瘤诊断及鉴别诊断的准确性。

Objective To summarize the radiological characteristics of giant cell tumor of bone in the pelvis and the key points of differential diagnosis. Methods 32 patients with giant cell tumor of bone in the pelvis were confirmed by surgery and pathological tests. The tumors located in the sacrum （n=lS）, the ilium （n=6）, the pubis （n=4） and the ischium （n-4）. All patients underwent x-ray, CT and MRI. The imaging manifestations were analyzed, and compared with the pathologic findings and confirmed with double blind method. Results The imaging features of giant cell tumor of the bone in the pelvis were expansive bony destruction, osteolytic destruction and soft tissue mass. Of all patients, 26 had expansive bony destruction, 6 had osteolytic destruction and 18 had soft tissue mass. Bony destruction was demonst rated more clearly on CT scan than that on x-ray. MRI could show the soft tissue and nervovascular bundle around the tumor clearly. Conclusions With the comprehensive understanding of x-ray, CT and MRI manifestations, the accuracy of the diagnosis and differential diagnosis of giant call tumor of bone in the pelvis can be improved.