The imaging analysis of solitary lesions in spine / 实用医学杂志

ABSTRACT

Objective Exploring the imaging findings of solitary lesions in spine to improve the diagnosis level of these diseases. Methods 158 cases of solitary lesions in spine confirmed by pathology from Jan 2011 to Jan 2018 were retrospectively analyzed on bone destruction, intralesional density, signal features, marginal sclerosis, boundary, soft tissue mass, periosteum reaction and involvement of intervertebral disc. Results There were 100 cases of primary bone tumors and tumor-like lesions, 25 cases of metastatic tumors and 33 cases of infectious diseases. 87 male and 71 female were included, with a mean age of (46.3 ± 7.2) years (range 5 ～76).There were 13 cases (8.23％) of benign bone tumors and 11 cases (6.96％) of benign tumor-like lesions, 21 cases (13.29％) of intermediate bone tumors and 4 cases (2.53％) of intermediate tumor-like lesions, 76 cases (48.10％) of malignant tumors and 33 cases (20.89％) of infectious diseases. Osteochondroma and fibrous dysplasia were the most common type of benign bone tumors and tumor-like lesions, respectively. Giant cell tumor and langerhans cell histiocytosis were the most common type of intermediate bone tumors and tumor-like lesions, respectively. Metastases and solitary plasmacytoma were the most common types of malignant tumors. Tuberculosis was the most common type of infectious diseases. Benign lesions usually have no or mild bone destruction. Clear boundary and marginal sclerosis were common, while periosteum reaction and soft tissue mass were rarely seen in benign lesions. Bone destruction with soft tissue mass and periosteum reaction were common in intermediate and malignant lesions. Moreover, malignant tumors usually had obscure boundary. Involvement of adjacent intervertebral disc was the most significant difference between infectious diseases and tumors and tumor-like lesions.Conclusions Solitary lesions in spine have certain regularity, which is helpful for the diagnosis and differential diagnosis of benign, malignant tumors and tumor-like lesions and infectious diseases.