四肢骨巨细胞瘤保肢术后的局部影像学评价

Imaging evaluation on local limb after salvage surgery in patients with giant cell tumor of limbs

目的探讨四肢骨巨细胞瘤保肢术后局部正常转归与并发症的影像学表现及其价值。方法分析104例因四肢骨巨细胞瘤而接受外科保肢治疗的患者的影像学随访资料,其中74例接受肿瘤刮除术(包括植骨术44例和骨水泥填充术30例),30例接受瘤段切除术(包括单纯切除术4例、移植骨重建术9例和肿瘤型假体关节置换重建术17例),术后平均随访时间(45.65±10.32)个月,分析术后随访的影像表现。结果 104例患者中,因手术方式不同,66例术后正常转归的影像学表现不尽相同。术后3年总并发症发生率为36.54%(38/104),随手术方式而有所不同;肿瘤复发率为28.85%(30/104)。结论在骨巨细胞瘤保肢术后随访中,影像学检查可较早发现局部并发症。

Objective To investigate imaging findings and value of local normal outcome and complications of giant cell tumor of limbs after limb salvage surgery. Methods Totally 104 patients with giant cell tumor of limbs after limb salvage surgery were followed up, and the imaging data were reviewed. Clinical tumor curettage was performed in 74 patients, including 44 patients filled with bone graft and 30 patients with bone cement. Tumor resection was done in 30 patients, including 4 with simple excision, 9 with autologous or allogeneic bone graft, and 17 with artificial tumor-type joint implantation. The average follow-up time after operation was more than （45.65 ± 10.32） months, and the postoperative imaging findings were analyzed. Results During the following up of 104 patients after giant cell tumor limb salvage surgery, different normal postoperative imaging findings were found in 66 patients underwent different surgical treatment. The overall complication rate during 3-year following-up was 36.54%（38/104）, and the recurrence rate was 28. 85% （30/104）. Conclusion Imaging examinations play an important role in the following-up of giant cell tumor limb salvage surgery, which are able to detect early local postoperative complications.