CT联合DCE-MRI在鉴别骶尾部骨巨细胞瘤和脊索瘤的价值研究
Research for the Value of CT and DCE-MRI for Identificating Sacrococcygeal Bone Giant Cell Tumors and Chordoma
袁逍 1李玮 1马冯慧 1李燕燕 1赵海艳 2鲍花 2左林1
作者信息
- 1. 空军军医大学附属第二医院放射科(陕西西安 710038)
- 2. 空军军医大学附属第二医院康复理疗科(陕西西安 710038)
- 折叠
摘要
目的 CT联合DCE-MRI-TIC曲线变化分析对比骶尾部脊索瘤和骨巨细胞瘤影像特征.方法 回顾性分析35例骶尾部脊索瘤及骨巨细胞瘤患者的CT、核磁共振影像资料,所有病例均有手术病理结果.脊索瘤患者21人,骨巨细胞瘤患者14人.病程15天至5年.结果 35名患者全部接受了CT平扫、DCE-MRI检查.19例脊索瘤患者肿瘤多发生于S3椎体以下部位,靠近脊椎中线;12例骨巨细胞瘤以S2椎体及以上部位发生、偏离中轴骨,8例骨巨细胞瘤累及骶髂关节.脊索瘤CT影像上常表现为形态不规则,可见残存骨或钙质密度影,以致正常椎体形态消失或被包块代替;而骨巨细胞瘤常造成椎体骨壳不完整,但椎体轮廓尚可见.MRI上脊索瘤病灶内见高或更高T2信号影伴点、片状低信号结节,骨巨细胞瘤多呈等或稍高信号影.DCE-MRI脊索瘤具有延迟强的特点,TIC曲线类型多呈流入型;而大部分骨巨细胞瘤多早期呈显著强化而后造影剂迅速减退,信号减低;MCER、EP平均值较脊索瘤组明显升高,TIC曲线类型多呈流出型.结论 CT联合DEC-MRI有助于骶尾部脊索瘤与骨巨细胞瘤的诊断及鉴别诊断,能为临床提供可靠的影像依据.
Abstract
Objective To analyze and compare the DCE-MRI-TIC、CT features of sacrococcygeal chordoma and giant cell tumor of bone.Methods The CT and MRI data of 35 cases of sacrococcygeal chordoma and giant cell tumor of bone were retrospectively analyzed.All cases had pathological results.There were 21 patients with chordoma and 14 patients with giant cell tumor of bone.The course of illness ranges from 15 days to 5 years.Results All 35 patients underwent CT and DCE-MRI examinations.The tumors of 19 patients with chordoma were mostly located below the S3 vertebral body,near the midline of the spine.12 patients with giant cell tumor of bone occurred in the S2 vertebrae and above,deviating from the axial bone,and 8 of them involved the sacroiliac joint.Chordoma often shows irregular shape on CT images,with residual bone or calcium density shadows,so that the normal vertebral body shape disappears or is replaced by mass.However,giant cell tumor of bone often results in incomplete vertebral shell,but the vertebral outline is still visible.MRI images showed high or higher T2 signal shadow points and lamellar low signal nodules in chordoma lesions.Giant cell tumors of bone mostly showed equal or slightly higher signal shadows.DCE-MRI chordoma has the characteristic of strong delay,TIC curve type is mostly inflow type.However,most of the giant cell tumors of bone showed significant enhancement in the early stage,and then the contrast agent rapidly decreased and the signal decreased.The mean values of MCER and EP were significantly higher than those of chordoma group,and the TIC curve types were mostly outflow type.Conclusion CT combined with DEC-MRI is helpful for the diagnosis and differential diagnosis of sacrococcygeal chordoma and giant cell tumor of bone,and can provide a reliable image basis for clinic.
关键词
脊索瘤/骨巨细胞瘤/CT/DCE-MRI/TIC曲线/鉴别诊断Key words
Chordoma/Giant Cell Tumor of Bone/CT/DCE-MRI/TIC Curve/Differential Diagnosis引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据