Imaging analysis and differential diagnosis of giant cell tumor of spine

Objective To analyze the imaging features of giant cell tumor(GCT)in the spine, and to improve the diagnosis. Methods The plain radiography, CT and MRI data of 36 patients with GCT in the spine confirmed by postoperative pathology were retrospectively analyzed. Results Of the 36 cases, 7 were found in the cervical spine, 16 in the thoracic spine, 6 in the lumbar spine, and 7 in the sacral spine.Aneurysmal bone cyst(ABC)was simultaneously detected in 9 of 36 cases.Typical features of the radiology show eccentric and distensible bone destruction of the involved vertebra in 25 cases.Twelve of the 27 cases without prior operation were detected pathologic fracture on imaging, spinal canal stenosis in 21, paraspinal soft tissue mass in 20 and cystic change in 17.Nine recurrent patients showed soft tissue mass without clear boundary and spinal canal stenosis.Seven of them showed cystic change and hemorrhage.Most lesions showed hypointense or isointense on T1-weighted imaging(T1WI)and hypointense, isointerse or heterogeneous high signal on T2-weighted imaging(T2WI). When ABC was detected, MRI revealed a mass with a fluid-fluid interface with polycystic hyperintense signal. Conclusion Radiographic features of the GCT in the spine are specific for diagnosis to some extent.Multiple imaging methods may contribute to the accuracy of preoperative diagnosis.CT combined with MRI has important value in GCT preoperative diagnosis, clinical staging, surgical strategies and postoperative evaluation. Key words: Spine; Giant cell tumor; Computed tomography; Magnetic resonance imaging