Bullmann V, Liljenqvist U
Abteilung für Wirbelsäulenchirurgie, Orthopädische Klinik II, St.-Franziskus-Hospital Köln, Schönsteinstr. 63, 50825, Köln, Deutschland.
Orthopade. 2013 Sep;42(9):700-8. doi: 10.1007/s00132-013-2065-5.
Diagnostic radiology and magnetic resonance imaging (MRI) are the most important imaging tools in the evaluation of benign bone tumors. Computed tomography (CT) is an additional tool for bony lesions, such as in cases of confirmation of the diagnosis of osteoid osteomas. For benign bony lesions three-stage skeletal scintigraphy is an optional additional diagnostic tool. The identification of benign or semimalignant bone tumors is not always clear; therefore percutaneous biopsy is necessary in most cases. In benign spinal tumors an intralesional curettage with reconstruction and stabilization is sufficient. In cases of semimalignant tumors, e.g. giant cell tumors localized in the spine, an en bloc resection is necessary because of the high recurrence rate.
诊断放射学和磁共振成像(MRI)是评估良性骨肿瘤最重要的成像工具。计算机断层扫描(CT)是用于骨病变的另一种工具,例如在确诊骨样骨瘤的病例中。对于良性骨病变,三相骨闪烁显像术是一种可供选择的辅助诊断工具。良性或半恶性骨肿瘤的鉴别并不总是明确的;因此在大多数情况下需要进行经皮活检。对于良性脊柱肿瘤,病灶内刮除术并进行重建和稳定处理就足够了。在半恶性肿瘤的情况下,例如位于脊柱的巨细胞瘤,由于复发率高,需要进行整块切除。