不同病理类型脊柱骨肿瘤的X线、CT及MRI的影像征象特点及诊断价值

Imaging Findings and Diagnostic Value of X-ray, CT and MRI in Different Pathological Types of Spinal Bone Tumors

目的分析不同病理类型脊柱骨肿瘤X线、CT、MRI影像征象特点及诊断价值。方法回顾性分析2011年3月-2016年7月我院收治的52例脊柱骨肿瘤患者的临床资料,所有患者入院后均完成X线、CT、MRI检查,总结不同病理类型脊柱骨肿瘤患者影像学特点。结果 (1)本组良性骨肿瘤13例,主要分布于腰椎,其次为颈椎、胸椎,以血管瘤、纤维结构不良常见;中间性骨肿瘤15例,主要分布于胸椎、腰椎,以骨母细胞瘤、骨巨细胞瘤、朗格汉斯细胞组织细胞增多症多见;恶性骨肿瘤34例,主要分布于胸椎,其次为腰椎,以浆细胞骨髓瘤、非霍奇金淋巴瘤常见。(2)MRI诊断不同病理类型脊柱骨肿瘤准确率最高(76.92%、80.00%、83.33%),其次为CT(61.54%、73.33%、75.00%),其中MRI诊断整体准确率(80.77%)高于X线(55.77%)(P<0.05)。结论 MRI对不同病理类型脊柱骨肿瘤诊断准确率最高,对X线、CT无法确诊脊柱骨肿瘤可进一步进行MRI筛查,以减少漏诊,为临床治疗奠定影像学依据。

Objective To analyze the imaging findings and diagnostic value of X ray,CT and MRI in different pathological types of spinal bone tumors.Methods The clinical data of 52 cases of patients with spinal bone tumors treated in our hospital from March 2011 to July 2016 were retrospectively analyzed.All patients were examined with X-ray,CT and MRI.The imaging findings of patients with different pathological types of spinal bone tumors were summarized.Results①In the study,there were 13 cases of benign bone tumors,mainly distributed in the lumbar vertebra,then in cervical vertebrae,thoracic vertebra,and hemangiomas and fibrous dysplasia were common.There were 15 cases of intermediate bone tumors,mainly distributed in the thoracic vertebra and lumbar vertebra,and osteoblastoma,giant cell tumor,Langerhans cell histiocytosis were common.There were 34 cases of malignant bone tumors,mainly distributed in the thoracic vertebra,then in lumbar vertebra,and plasma cell myeloma and non-Hodgkin lymphoma were common.②The accuracy rates of MRI in the diagnosis of different pathological types of spinal bone tumors were the highest(76.92%,80.00%,83.33%),followed by CT(61.54%,73.33%,75.00%),and the overall diagnostic accuracy of MRI(80.77%)was higher than that of X-ray(55.77%)(P<0.05).Conclusion The accuracy of MRI in the diagnosis of different pathological types of spinal bone tumors is the highest.For spinal bone tumors that can not be diagnosed by X-ray and CT,they can be further screened by MRI to reduce missed diagnosis,provide imaging evidences for clinical treatment.