颅骨巨细胞瘤的影像学诊断

Radiology features of giant cell tumors of the skull

目的分析颅骨骨巨细胞瘤的CT和MRI表现。方法收集8例经手术和病理证实的颅骨骨巨细胞瘤。全部病例均行CT和MRI检查(其中6例行增强CT检查,5例行增强MRI检查)。所有病例均行外科手术切除。术后2周,行放射治疗,剂量4500～6000cGy,时间为5～6周。结果CT显示不同程度的骨质破坏和钙化。大部分肿瘤边界清晰,MRIT1加权像呈低信号,T2加权像呈不均匀信号。T1加权像低信号区在T2加权像上随回波时间延长信号仍呈低信号而提示钙化。所有病例术后随访均无明显变化。结论CT能准确显示骨质破坏情况及钙化程度,MRI在显示病变的范围方面要优于CT,两者结合是诊断颅骨骨巨细胞瘤的最佳影像学检查方法。手术切除与术后放疗相结合是治疗颅骨骨巨细胞瘤较好的方法。

Objective To analyze the CT and MRI features of giant cell tumors of the skull. Methods 8 cases of giant cell tumors of the skull proven surgically and pathologically were analyzed retrospectively. CT and MRI(6 cases with post contrast CT and 5 cases with post contrast MRI scans)were performed in all cases. All tumors were excised surgically. Two weeks later,all patients undertook postoperative radiotherapy with the dosage of 4 500-6 000 cGy for five to six weeks. Results CT scan showed bone destruction and calcification. Most of the tumours were well defined with low signal intensities on T1 WI images, T2 WI images showed ununiformity signal. The low signal on T1 WI was still low signal intensity on T2 WI which suggested calcification. All patients had no distinctive change within the follow up period. Conclusion CT is able to clearly show bone destruction and calcification. MRI is superior to CT in demonstrating the outlines of the tumours. CT and MRI are effective methods in the diagnosis of the giant cell tumors. Surgery and postoperative radiotherapy are effective methods in the treatment of the giant cell tumors.