骨巨细胞瘤的影像学诊断

目的：探讨骨巨细胞瘤的平片、CT、MRI影像学表现，评价其诊断价值。方法：对16例经临床手术病理学证实的骨巨细胞瘤病例的X线平片、CT和MRI影像学资料进行回顾性分析。结果：9例长骨病灶分布主要在骨性关节面下方，以偏向性膨胀性骨破坏为主，周围硬化不明显，中央无钙化；增强后有不均匀强化效应；其中2例合并动脉瘤样骨囊肿者见液-液平面。7例脊柱和不典型部位病灶以膨胀性骨破坏为特点，周围硬化不明显，脊柱病灶同时见周围软组织肿块形成，中心无钙化；其中1例脊柱病灶同时累及相邻三个椎体。骶椎病灶分布位置偏高，在骶椎1～2水平。结论：大多数骨巨细胞瘤有典型的X线表现，不难作出正确的诊断；CT和MILI能提供更多的信息来提高诊断和鉴别诊断能力。

Imaging diagnosis of giant cell tumor of bone

Objective：To analyze the imaging appearance and to evaluate the diagnostic value of X-ray, CT, and MRI in giant cell tumor of bone（GCT）. Methods： Data on X-ray, CT and MRI of 16 cases of giant cell tumor proved by pathology, were reviewed. Resuits：9 cases of long tubular bone located epiphyscal ends. The common radiographic features were eccentric, expanded bony destruction. No obvious sclerosis in peripheral and calcification in centre area. There was inhomogeneous enhancement after contrast examination. Fluid-fluid level in MRI imaging were found in 2 cases with aneurysmal bony cyst. 7 cases of spine and atypical position had the radiographic features of expanded bony destruction, no obvious sclerosis in margin and calcification in centre, soft tissue mass could be found in spine. One of them involved three adjacent vertebrates. Tile lesion located in scrum distributed upper part, commonly in S1 - 2. Conclusion： Most of GCT have typical X-ray appearance and there is no difficult in making a correct diagnosis. CT and MRI supply more information and the capability of differential diagnosis may be improved.