下肢骨巨细胞瘤CT和MRI影像学表现与术后复发的相关性分析

An Analysis On The Correlation Between Recurrence of GCTB in Lower Limbs and Its CT and MR Imaging

目的回顾性分析下肢骨巨细胞瘤CT和MRI表现与术后复发的相关性,为预测术后复发及制定临床诊疗方案提供影像学依据。方法回顾1999年至2014年59例下肢骨单发骨巨细胞瘤患者术后复发情况,分析其术前CT与MRI影像资料。观察CT骨棘与骨皮质破坏表现及MRI囊性变、周围组织水肿、瘤内液化坏死出血、软组织侵袭及肿瘤边缘低信号是否完整等表现,并分析以上表现与复发的相关性。结果 MRI所示的瘤内出血液化坏死表现在复发与无复发两组中具有统计学差异(P<0.05)。其余影像学表现在复发与无复发两组中均无统计学差异。结论骨巨细胞瘤MRI所示的瘤内出血液化坏死表现与肿瘤术后复发相关,对临床治疗方案的制定具有指导意义。

Objective To investigate the correlation between the CT and MRI imaging of GCTB in the lower limbs and recurrence after surgery retrospectively,and to guide clinical treatment as well as predicting prognosis.Methods 59 cases diagnosed with GCTB in the lower limbs from 1999 to 2014 are analyzed retrospectively.The pre-operative CT and MRI imaging of 59 cases were collected.CT images were analyzed for presentation of bone crest and cortical breaking.MRI images were analyzed for presentation of cystic change,liquefaction/necrosis/hemorrhage,edema of the surrounding tissue,soft tissue extension and the integrity of the low signal margin.All data and information mentioned above are collected and analyzed to study the association with postoperative recurrence.Results The manifestation of hemorrhage/liquefaction/necrosis has significant difference between recurrence and non-recurrence（P〈0.05）.Conversely,other presentations had no significant difference.Conclusion The manifestation of hemorrhage/liquefaction/necrosis observed on MRI images is associated with postoperative recurrence,which can offer guidance to clinical treatment.