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目的:探讨脊椎骨母细胞瘤的磁共振(MRI)表现、诊断价值及其临床特点。方法:8例脊椎骨母细胞瘤患者,术前均行MRI检查,主要症状为四肢不全性瘫痪及疼痛,治疗上行肿瘤切除或刮除治疗,椎体病变者行植骨及内固定术。结果:8例均经病理确诊为骨母细胞瘤,其中6例为良性,2例为侵袭性。肿瘤起源于脊椎椎体2例,起源于脊椎附件6例;发病部位颈椎2例,胸椎3例,腰椎3例。脊椎骨母细胞瘤MRI主要表现为椎体或附件溶骨性膨胀性骨质破坏,T1WI上为低或等信号,T2WI上可为低、等或高多种信号成分,肿瘤内钙化或骨化在T2WI上为低信号,T1WI上为等或低信号;周边硬化环在T1WI和T2WI上均为低信号;软组织肿块较明显,向椎管突出可压迫脊髓;增强扫描肿瘤中度到明显强化,囊变、硬化边缘不强化。侵袭性骨母细胞瘤边界不清,可侵犯周围组织。结论:脊椎骨母细胞瘤发病年龄较轻,发病部位以脊椎附件较多见。MRI多方位、多序列成像及增强扫描,能较好显示脊椎骨母细胞瘤的各种病理改变,对诊断、手术定位、分期尤其在显示脊髓继发改变有重要价值。
Objective: To investigate the magnetic resonance imaging (MRI) performance, diagnostic value and clinical features of spinal osteoblastoma. METHODS: Eight patients with vertebral osteoblastoma underwent MRI examination before operation. The main symptoms were incomplete paralysis and pain in the extremities. The patients were treated with tumor resection or curettage, and those with vertebral lesions were treated with bone grafting and internal fixation. RESULTS: All the 8 cases were diagnosed with osteoblastoma by pathology. Among them, 6 cases were benign and 2 cases were invasive. The origin of the tumor was in the spine vertebral body in 2 cases, which originated from 6 cases of spinal attachments; 2 cases of cervical spine at the onset site, 3 cases of thoracic vertebrae, and 3 cases of lumbar vertebrae. In vertebral osteoblastoma, MRI mainly manifests as osteolytic disintegrative bone destruction in the vertebral body or accessories, low or equal signal on T1WI, low, equal or high signal components on T2WI, calcification or ossification in tumors. Low signal on T2WI, equal or low signal on T1WI; Peripheral sclerosis ring on the T1WI and T2WI are low signal; soft tissue mass is more obvious, to the spinal canal can oppress the spinal cord; enhanced scanning of the tumor moderate to markedly enhanced, capsule Change, hardening edge is not strengthened. The borderline of invasive osteoblastoma is unclear and can invade surrounding tissues. Conclusion: The age of onset of vertebral osteoblastoma is lighter, and the site of the disease is more common with spinal attachments. MRI multi-azimuth, multi-sequence imaging and enhanced scans can better show various pathological changes of vertebral osteoblastoma, and have important value in diagnosis, surgical positioning, staging, especially in displaying secondary changes of spinal cord.