骶骨巨细胞瘤的影像学诊断

目的探讨X线平片、CT及MRI对骶骨巨细胞瘤的诊断价值。方法回顾性分析经手术或病理证实的13例骶骨巨细胞瘤的影像学表现及临床资料。结果骶骨巨细胞瘤的X线及CT均表现为骶骨上部偏心性生长、皂泡样膨胀性溶骨性破坏，部分骨壳破坏中断，向前形成软组织肿块，增强扫描病变明显强化。MRI表现为T1WI呈低／等混杂信号，T2WI呈等／高不均匀信号；出血偶见，表现为T1WI、T2WI呈高信号，可出现单发／多发液-液平面。结论X线平片及CT扫描对骶骨巨细胞瘤有较重要诊断价值；MRI虽无特征性影像学表现，但可清晰显示病变范围及肿瘤与周围组织的关系。

Imaging Diagnosis of Sacral Giant Cell Tumors

Objective To analyze the appearances of X-ray film, CT and MRI in sacral giant cell tumors,and to study the differential diagnosis. Methods The image features of 13 patients with sacral giant cell tumors,proved by surgical pathology,were analyzed retrospectively, and among which all patients had X-ray film and CT, 8 patients had MRI. Results Soap bubble-like expansive bone destruction, eccentric growth of upper sacrum,partial pathologic fracture of bone shell and the soft tissue masse of anterior sacral were discovered by X- ray and CT in 13 cases,and these changes were more apparent in homogeneous nodular, slightly hypiontense to mixed hyper ＇intense on T1WI, and hypointense or slightly mixed hyper intense on T2WI were observed by MRI in 13 cases. Solitary or multiple fluid-fluid lever inside the lesion was discovered in cases. Conclusion X-ray film and CT have important diagnosis value in sacral giant cell tumors. MRI has no characteristic radiographic features, but can display clearly the extent of bony distraction and the relation between tumor and surrounding tissues.