脊椎巨细胞瘤的影像学诊断及其术前栓塞的临床应用价值

Imaging Diagnosis and Clinical Value of Preoperative Embolization of Spinal Giant Cell Tumor

目的 探讨脊椎巨细胞瘤的影像学特点及术前选择性动脉造影、栓塞对其术中出血 ,手术全切率和术后疗效的影响。方法 分析了 12例经手术病理证实的脊椎巨细胞瘤的影像学征象 ,并对肿瘤供血动脉行数字减影血管造影和术前栓塞处理。结果 脊椎巨细胞瘤的典型征象为具有溶骨性破坏边缘 ,破坏区有一定的膨胀性并呈皂泡状或分隔状骨嵴等特点。供血动脉栓塞后肿瘤染色大部分消失 ,术中出血明显减少。结论 ①X线平片是诊断本病的基本方法 ,但有一定的局限性。②CT及MRI能确定病变范围、大小、内部结构及软组织肿块 ,对X线不能显示的病变具有特殊诊断价值。③术前栓塞有助于减少术中出血 ,增加手术安全性 。

Purpose To investigate the imaging features of spinal giant cell tumor and to evaluate the influence of preoperative selective arteriography and embolization in reducing intraoperative hemorrhage and increasing cut rate of operation and treatment effect of spinal giant cell tumor. Methods The imaging features of 12 cases pathological confirmed spinal giant cell tumor have been analyzed. The preoperative selective digital subtraction arteriography and embolization have been carried out to suppling arteries. Results The typical imaging features of pathological changed vertebrae bones are dissolved bone border, expanded and soap bubble like inner structure, divided bone crest, etc. Most of the tumor dyeing of tumor suppling arteries disappeared after embolization and intraoperative hemorrhage induced obviously. Conclusion ①X ray plain film is the basic method to diagnose spinal giant cell tumor, but it has some limitation. ②CT and MRI can definite the scope, size, inner structure and soft swelling mass of pathological changed vertebrae bones and they have special value to show pathological changes which plain film can not show. ③Preoperative embolization is helpful to reduce intraoperative hemorrhage and increase cut rate and safe of operation and treatment effect of spinal giant cell tumor.