脊柱骨巨细胞瘤的CT与MRI诊断

目的探讨脊柱骨巨细胞瘤的CT、MRI表现及其诊断价值。方法本组17例为经手术病理证实的脊柱巨细胞瘤患者，男13例，女4例，平均年龄49岁；临床与影像学资料齐全。分析病灶的影像学特征及其对诊断与鉴别诊断意义。结果17例脊柱巨细胞肿瘤患者中颈椎5例，胸椎7例，腰椎2例，骶椎3例；14例仅累及1个椎体，3，例累及2个椎体。本组患者X线片示：11例表现为椎体溶骨性破坏并具一定的膨胀性，6例表现为椎体不同程度的压缩。CT示：椎体破坏区无骨性成分存留。MRI示：T1 WI为较均匀中至低信号，T2 WI为较均匀高信号，病灶部分呈良性的硬化骨边缘，部分终板破坏形成软组织肿块。结论脊柱巨细胞瘤影像学表现不同于四肢巨细胞瘤，瘤内无孵确骨性成分存留；可分为膨胀型和压缩型，兼有良、恶性肿瘤的影像学特征，主要应与脊柱动脉瘤样骨囊肿及转移瘤相鉴别。

Bone giant-cell tumor of the spine: MRI and CT findings

Objective To study the CT and MRI manifestations of spinal giant-cell tumor and its diagnostic value. Methods Seventeen cases of spinal giant-cell tumor were all confirmed by pathology after operation,including 13 males and 4 females with average age of 49 years. The clinical and radiographic datas of all the cases were intact,which were used to study the imaging characteristics and its value on diagnosis and differential diagnosis. Results Among the 17cases, there were 5 cases with tumors at cervical spine ,7 at thoracic ,2 at lumbar and 3 at sacral. Only one vertebral body was involved in 14 cases and two in 3 cases. The images showed osteolytic destruction of vertebral body with definite expansion in 11 cases and Vertebral compression in different degree in 6 cases L CT scans showed no bone shell left inside the destroyed vertebral body. MRI showed the lesions were of middle-to-low T1-weighted iso-signal and high T2-weighted iso-signal, part of which showed benign sclerotic rim and part showed no rim with soft tissue mass. Conclusion The imaging characteristic of spinal giant-cell tumor is different from that of extremity giant-cell tumor,which shows no bone shell left inside the tumor. Spinal giant-cell tumor has two types including expanded type and compressed type which both have benign and malignant imaging characteristics. Spiinal aneurysmal bone cyst and metastasis should be taken into account as diagnosis and differential diagnosis.