脊椎骨巨细胞瘤的X线片、CT及磁共振表现

X-ray,CT and MR manifestations of spinal giant cell tumor

目的探讨脊椎骨巨细胞瘤(GCT)的X线片、CT及磁共振(MR)表现,以提高对该病的影像诊断水平。方法回顾性分析经手术和病理证实的16例脊椎GCT的X线片、CT及MR资料,分析肿瘤的部位、大小、形态、边缘、X线片和CT密度或MR信号及强化形式。结果肿瘤位于颈椎4例,胸椎8例,腰椎4例;其中6例仅累及椎体,10例累及椎体和附件;8例侵犯相邻2个椎体,8例只累及1个椎体;16例均突入椎管、压迫脊髓。X线片和CT表现为椎体和(或)附件偏心性、溶骨性、膨胀性骨质破坏。MR表现为T1WI等或稍低信号,T2WI等或稍高信号。增强扫描16例病变的实性部分全部呈明显不均匀强化。结论脊椎GCT具有一定的影像学特征,CT和MR检查可以准确显示病变及肿瘤累及的范围,为临床制定治疗策略提供更准确的影像信息。

Objective To explore the X ray,CT and MR manifestations of spinal giant cell tumor（GCT） for improving the diag- nosis level of this rare disease. Methods The X-ray,CT and MR data in 16 cases of spinal GCT were retrospectively analyzed on the location, size,morphology,margin,CT density/MR signal intensity and enhancement pattern. Results 4 cases located in cervical vertebra,8 cases in thoracic vertebra and 4 cases in lumbar vertebra^in which,6 cases only involved in vertebral body and other 10 cases involved in vertebral body and and appendix. The lesion affected two neighboring vertebrae in 8 cases, and affected only one vertebra in the remaining 8 cases. 16 cases were protruded into the spinal canals and oppressed the spinal cord. The prominent X ray and CT images showed eccentric growth,osteolytic and swelling hone destruction. MR showed isointensity or slight hypointensity on T1 WI, and isointensity or slight hyperintensity on T2 WI. After intensified scanning, the solid portion showed marked inhomoge- neous enhancement. Conclusion Spinal GCT has certain imaging characteristics. CT and MR examination could accurately display the extent of lesion and tumor involvement, which provides more accurate image information for formulating the strategy of clinical therapy.