活动脊柱骨巨细胞瘤的影像学表现

摘要

Objective:To investigate the imaging findings of giant cell tumor (GCT) of mobile spine,so as to discuss the clin-ic feature and differential diagnosis. Methods:Imaging appearances of 16 cases of giant cell tumor of mobile spine proved by operation and pathology were retrospectively analysed. All patients were examined with X-Ray,11 patients received MRI scan,5 patients received whole-body bone scanning and local SPECT-CT. The imaging findings were compared with the pathologic diag-nosis and confirmed by double blind method. Results:Among 16 cases of GCT,4 cases were at cervical vertebrae,7 cases were at thoracic vertebra,5 cases were at lumbar vertebra. X-ray and CT imaging showed aggressive and lytic lesion of centrum. Ex-pansive growth was in 12 cases,bony ridge was seen in 7 cases,7 patient showed pathological fractures and compression of centrum,11 cases showed surrounding soft tissue mass of centrum. The tumor showed low signal at T1WI,7 lesions showed low and iso- or hypo-intense signal and 4 lesions showed high-low mixed signs on T2WI. Cord compression was seen in 8 cases. Homogeneous and inhomogeneous enhancement was observed in 6 and 5 cases. Increased ringlike radionuclide uptake and de-crease radionuclide uptake was shown in the central region in whole-body bone scanning and local SPECT-CT. Conclusion:The imaging features of giant cell tumor of mobile spine are intralesional bony ridge,iso- or hypo-intense signal on T2WI and"doughnut" on whole-body bone scanning.%目的:探讨活动脊柱骨巨细胞瘤(giant-cell tumor,GCT)的影像学表现及鉴别特点. 方法:回顾性分析经手术病理证实的16 例活动脊柱GCT的影像学表现,患者均行X线及CT检查,11 例行MRI平扫及增强扫描,5 例行全身骨显像及局部SPECT-CT检查,对其影像学表现与病理结果进行对照.结果:本组16例,病变位于颈椎4例,胸椎7例,腰椎5例.X线及CT表现为椎体侵袭性溶骨性骨质破坏,病灶呈膨胀性生长12例,7例内可见骨嵴分隔,椎体压缩塌陷伴病理骨折7例,11例椎体周围伴有软组织肿块. MRI表现为T1WI等低信号,T2WI以等或低信号为主7例、高低混杂信号4例;8例相应脊髓受压;增强扫描6例呈均匀明显强化,5例呈不均匀明显强化. 局部SPECT-CT及全身骨显像表现肿瘤为环状放射性核素摄取增加,中央部位摄取减低呈"炸面圈征". 结论:活动脊柱GCT影像学表现具有一定特征,瘤内粗短骨嵴分隔、T2WI中等或偏低信号及放射性核素骨显像呈"炸面圈征"是其特征性表现.