Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Radiol Med. 2013 Apr;118(3):456-64. doi: 10.1007/s11547-012-0860-4. Epub 2012 Aug 8.
This study was done to investigate X-ray, computed tomography (CT) and magnetic resonance (MR) imaging features of recurrence in giant cell tumour of bone (GCTB) and to evaluate risk factors.
Medical records and imaging data were reviewed for 55 cases of recurrent GCTB. All images were reviewed retrospectively and independently by two radiologists experienced in skeletal musculature. The common radiological findings; factors related to tumour recurrence such as gender, age, location; pathological fracture, Campanacci grading and surgical procedure were analysed by nonparametric test (Mann-Whitney U test for two independent samples test and Kruskal-Wallis H test for multiple independent samples test). p values <0.05 were considered to indicate a statistically significant difference.
The imaging features of recurrent GCTB were as follows: osteolytic destruction or bone resorption of graft bone or around the polymethylmethacrylate (PMMA), soft tissue mass formation and expansile change. Tumour parenchyma showed markedly heterogeneous enhancement, except for necrotic cystic cavities, on contrast-enhanced MR images. Wide resection had a smaller (p=0.031) risk of local recurrence than did intralesional curettage. There was no statistical significance in gender, age, location, pathological fracture and Campanacci staging (p>0.05).
The risk of recurrence in GCTB was influenced by the type of surgery and adjuvants. Bone transformaresorption, soft tissue mass formation and aggravated expansile change are reliable signs of recurrence on imaging.
本研究旨在探讨骨巨细胞瘤（GCTB）复发的 X 线、计算机断层扫描（CT）和磁共振（MR）成像特征，并评估其危险因素。
回顾性分析了 55 例复发性 GCTB 患者的病历和影像学资料。所有图像均由 2 名具有骨骼肌肉放射学经验的放射科医生进行回顾性独立分析。通过非参数检验（Mann-Whitney U 检验用于两独立样本检验和 Kruskal-Wallis H 检验用于多独立样本检验）分析常见的影像学发现、与肿瘤复发相关的因素（如性别、年龄、部位、病理性骨折、Campanacci 分级和手术方式）。p 值<0.05 被认为具有统计学意义。
复发性 GCTB 的影像学特征如下：移植物骨或聚甲基丙烯酸甲酯（PMMA）周围的溶骨性破坏或骨质吸收、软组织肿块形成和膨胀性改变。肿瘤实质在增强 MR 图像上呈明显不均匀强化，除了坏死性囊性腔外。广泛切除比腔内刮除术具有更小的（p=0.031）局部复发风险。性别、年龄、部位、病理性骨折和 Campanacci 分级之间无统计学意义（p>0.05）。
手术类型和辅助治疗影响 GCTB 的复发风险。骨转换吸收、软组织肿块形成和加重的膨胀性改变是影像学上复发的可靠征象。
