A Study On The Correlation Between Recurrence Of Gctb In Lower Limbs And Its CT And MR Imaging

Purpose The aim of this study is to investigate the correlation between the CT and MRI imaging of GCTB in lower limbs and recurrence after surgery retrospectively,and to guide clinical treatment and prognosis.Method We analyzed 59 cases with GCTB retrospectively from 1999 to 2014 treated in orthopedics department of Ruijin Hospital affiliated to Shanghai Jiaotong University.All the cases were diagnosed by pathologists with GCTB in lower limbs and with complete follow-up information.The pre-operative CT and MRI imaging of 59 cases were collected.All the potential risk factors for postoperative recurrence,such as age,sex,location and surgery.CT images were analyzed for tumor size and observation of bone crest and cortical breaking.MRI images were analyzed for the tumor size,the distance to the articular surface,and observation of cystic change,liquefaction/ necrosis/hemorrhage manifestations,edema of the surrounding tissue,soft tissue extension and the integrity of low signal margin.All data and information mentioned above are collected and analyzed by groups of recurrence and nonrecurrence to study the association with postoperative recurrence.T test is used for numerical analysis and chi-square test is used for categorical variables.Results Of 59 patients,26 cases are male,33 cases are female.The male/female ratio is 1:1.3.The average age is 33.9 years old(18~64 years old).49 cases(83%)occurred in 20 ~ 50 years old.Distal femur,proximal tibia and proximal femur are the most common sites.About 78% of the cases occurred around the knee.51 cases were treated by curettage,and 8 cases treated with en bloc/wide resection.All the cases were followed up at least 2 years.Of all the cases,27 cases are with recurrence(45.8%).The average recurrence time is 2.1 years after surgery(0.5~8 years),and 77.8% of the recurrence occurred within 2 years after surgery.The manifestation of hemorrhage/liquefaction/necrosis has significant difference between recurrence and no recurrence,whereas the remaining12 factors have no significant difference.Conclusion The manifestation of hemorrhage/liquefaction/necrosis observed on MRI images is more common in recurrent cases,and associated with postoperative recurrence.