骨巨细胞瘤影像学诊断价值的比较

The Comparison of Diagnostic Value of Imaging in the Giant Cell Tumor of Bone

目的通过骨巨细胞瘤常见和典型的X线、CT及MRI表现的比较,提高对该病诊断和鉴别诊断的能力。方法回顾性分析19例经手术病理证实为骨巨细胞瘤患者的X线、CT及MRI表现。结果 X线平片表现:溶骨性骨质破坏14例,均呈膨胀性生长,边界尚清晰;硬化性骨质破坏1例,病理性骨折。CT表现:13例呈偏心膨胀性骨质破坏,均见局限性硬化边,12例见棘状、尖角状、条索状骨嵴及硬化边征象,10例软组织肿块影。MRI表现:7例MRI T1WI上均主体呈等信号夹杂少量低信号,T2WI及T2压脂相呈低信号等信号、高混杂信号,DWI呈高信号。结论骨巨细胞瘤的影像学表现为偏心性、膨胀性溶骨破坏,X线平片、CT及MRI影像检查相互补充,能够增加骨巨细胞瘤诊断及鉴别诊断的准确性。

Objective To improve the diagnosis and differential diagnosis of giant cell tumor of bone through comparing the common and typical X-ray, CT and MRI manifestations. Methods The X-ray, CT and MRI manifestations were analyzed retrospectively in the 19 patients with giant cell tumor of bone confirmed by surgical-pathology. Results X-ray representation： the 14 cases of osteolytic bone destruction, showed the expansive growth, the border was still clear; the 1 case of sclerosing bone destruction ,the pathologic fracture was observed. CT representa-tion： the 13 cases were bone destruction of eccentric expansion,the limitations of hardened edge could be observed; spiny,sharp,angular, cord-like ridge and hardened edge signs could be observed in the 12 cases; the 10 cases showed the soft tissue mass. MRI representation： T1WI of MRI in the 7 cases showed the other signal while mixed with a small amount of low signal; T2 WI and T2 fat suppression imagings showed low signal and high-mix signal; DWI showed high signal. Conclusion The characterization of imaging of giant cell tumor of bone were eccentric and expansive osteolytic destruction; and the X-ray, CT and MRI could complement each other, increase the accuracy of diagnosis and differential diagnosis of giant cell tumor of bone.