摘要
目的总结肺癌脊柱骨转移的影像学变化特点，了解不同影像检查方法的优缺点。方法收集全身骨静态扫描（ECT）检查有阳性表现的35～85岁肺癌脊柱骨转移患者76例，追查其中进行过CT或MRI全脊柱检查的病例55例，观察三种检查方法在反应肺癌脊柱骨转移的不同影像学表现，比较三种检查方法诊断肺癌脊柱骨转移的敏感度。结果①55例CT和MRI显像后的骨质改变表现：呈溶骨性破坏者39例（70．9%），蜂窝状溶骨性骨破坏11例（20．0％）；呈小片状、斑片状成骨性改变4例（7．3％），兼有溶骨性及成骨性的混合性骨转移1例（1．8％）。②CT检查40例中，阳性17例，敏感度为42．5％，假阴性率57．5％。相同照射野中，ECT比CT多检出11个病灶。③MRI检查15例中，阳性14例，敏感度为93．3％，假阴性率6．7％。相同照射野中，MRI比ECT多检出8个病灶。结论MRI与ECT对肺癌脊柱骨转移的发现敏感度高，且MRI易发现多发隐匿性病灶，在肺癌脊柱骨转移的诊断中较CT具有明显的优势。如果临床或ECT检查高度怀疑肺癌脊柱骨转移，应该尽早或首选MRI检查。
Objectives To summarize the imaging changes in lung cancer patients with vertebral metastasis. Methods 76 patients with vertebral metastasis in lung cancer were collected with the positive identification of emission computed tomograpy （ECT）. 55 cases undertook CT or MRI test on integrated vertebral scanning. The different imaging changes in those cases with different testing and the sensitivity were observed. Results The imaging of CT and MRI showed that there were 39 cases （70.9%） of osteolytic destruction. There were 11 cases （20. 0%） with honeycomb-like osteolytic bone destruction and 4 cases （7. 3%） with osteoblastic changes with small flake or patchy appearance. The sensitivity of CT was 42.5% and false-negative rate was 57.5%. In the same radiation field, ECT overrode CT by discovering 11 more focus. The sensitivity of MRI was 93.3% and false-negative rate was 6.7%. In the same radiation field, MRI overrode ECT by discovering 8 more focus. Conclusion MRI and ECT have a higher sensitivity than CT in diagnose the lung cancer patients with vertebral metastasis. MRI is recommend to those suspected because it has a advantage in discovering metastasis especially the Occult lesions
出处
《西部医学》
2010年第4期627-629,共3页
Medical Journal of West China
关键词
肺肿瘤
椎骨
肿瘤转移
影像分析
Lung cancer
Vertebra
Metastasis
Image Analysis
