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目的分析脊柱骨巨细胞瘤(GCT)的影像学表现及临床意义。方法回顾性分析本院收治由病理证实的脊柱GCT30例(男13例,女17例,年龄17~69岁,平均32.6岁)。所有病例拍摄病变节段X线正侧位片,22例行CT检查,16例有MRI检查。结果发生于颈椎1例,胸椎10例,腰椎6例,骶椎13例,其中术后复发7例,肺转移1例。X线平片表现为侵袭性溶骨破坏及椎体压缩改变;CT主要表现为膨胀性溶骨性破坏和较大软组织肿块;其MRI表现T1WI多为低等信号;T2WI为高低混杂信号特点。结论结合X线平片、CT、MRI等影像检查可对脊柱GCT做出明确诊断。CT和MRI可提供更多信息,对临床分期、手术方案制订及术后评估有重要价值。
Objective To analyze the imaging findings and clinical significance of giant cell tumor of the spine (GCT). Methods Retrospective analysis of 30 cases of GCT confirmed by pathology in our hospital (13 males and 17 females, aged 17-69 years, average 32.6 years old). In all cases, X-ray films of lesion segments were taken, CT was performed in 22 cases and MRI was performed in 16 cases. The results occurred in 1 case of cervical spine, 10 cases of thoracic spine, 6 cases of lumbar spine, 13 cases of sacral vertebrae, including 7 cases of postoperative recurrence and 1 case of pulmonary metastasis. X-ray film showed the destruction of invasive osteolytic and vertebral compression changes; CT mainly for expansive osteolytic destruction and larger soft tissue mass; its MRI T1WI mostly low signal; T2WI high and low mixed signal characteristics. Conclusion Combined with X-ray, CT, MRI and other imaging examination can make a clear diagnosis of GCT of the spine. CT and MRI can provide more information, clinical staging, surgical planning and postoperative evaluation of great value.