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目的探讨脊椎骨巨细胞瘤的多层螺旋CT(MSCT)与MRI表现,以提高其诊断准确率。方法分析19例经穿刺或手术病理证实的脊椎骨巨细胞瘤患者的临床资料及MSCT、MRI表现。结果 19例脊椎骨巨细胞瘤中发生于胸椎5例、腰椎4例、骶椎9例,同时累及骶尾骨1例。MSCT显示椎体呈不同程度膨胀性溶骨性骨质破坏,内见骨嵴分隔;病灶呈偏侧性生长,大部分累及一侧附件;椎体呈不同程度压缩改变。MRI显示除1例因病灶内出血T1WI序列呈高低混杂信号外,其余T1WI序列均为低或等信号,T2WI序列高信号,病灶信号不均匀,内可见多发囊变、坏死信号;Gd-DTPA增强后,病灶呈不均匀中度到明显强化。结论 MSCT、MRI结合,能提供比较全面的影像学信息,对准确诊断脊椎骨巨细胞瘤具有很高的价值。
Objective To investigate the multi-slice spiral CT (MSCT) and MRI manifestations of giant cell tumor of vertebrae in order to improve the diagnostic accuracy. Methods The clinical data and MSCT and MRI findings of 19 patients with giant cell tumor of vertebrae confirmed by puncture or pathology were analyzed. Results 19 cases of giant cell tumor of vertebra occurred in 5 cases of thoracic vertebrae, 4 cases of lumbar vertebrae, 9 cases of sacral vertebrae and 1 case of sacrococcygeal. MSCT showed that the vertebral bodies showed varying degrees of osteolytic osteolysis with segmental bone crest separation. The lesions showed lateral growth and most of the involved side attachments. Vertebral bodies were compressed to varying degrees. MRI showed that all the T1WI sequences were low or equal signal except T1WI sequence, high signal of T2WI sequence and uneven signal of lesion, multiple cystic and necrotic signals were seen in 1 case. , The lesions were uneven to significantly enhanced. Conclusion The combination of MSCT and MRI can provide more comprehensive imaging information and is of great value in the accurate diagnosis of giant cell tumor of the spine.