摘要
常规临床实践中,CT和MRI经常发现偶发的孤立性骨病变,而这些病变的诊断管理一直缺乏清晰一致的指南。针对以上情况,2022年9月份,国际骨骼放射学会(SSR)实践指南和技术标准委员会发布了全球第1版骨影像报告和数据系统(Bone-RADS),旨在规范孤立性骨病变的CT和MRI诊断管理流程,对CT骨透亮影、硬化性、混杂密度骨病变,以及MRI T1WI高信号、T1WI等或低信号、T2WI高和低信号骨病变做了详细定义,并依据两种CT分类(透亮影、硬化性或混杂密度影)、两种MRI分类(T1WI高信号、T1WI低信号)分别提供了对应的诊断管理流程,共分为4类:Bone-RADS 1,无需处理;Bone-RADS 2,建议其他影像学检查;Bone-RADS 3,建议随访复查;Bone-RADS 4,建议活检和/或骨肿瘤转诊。文章拟对该Bone-RADS进行详细解读,有利于广大放射科医师更好地掌握成人CT和MRI偶发孤立性骨病变的诊断管理。
In routine clinical practice,occasional isolated bone lesions are often encountered in CT and MRI,but there has been a lack of clear and consistent guidelines on the management of these occasional lesions.For this situation,the practice guidelines and technical standards committee of Society of Skeletal Radiology released first version bone imaging reporting and data system(Bone-RADS)in September 2022,aiming to present algorithms for the diagnostic management of these solitary bone lesions.The guideline defines the CT lucent lesion,sclerotic and mixed lesions,and MRI T1 hyperintense lesions,T1 isointense/hypointense lesions,and T2 hypointense and hyperintense lesions.Based on two CT classifications(bone lysis,sclerosis/mixed)and two MRI classifications(T1 isointense,T1 hypointense lesions),the guidelines provide four corresponding diagnostic management algorithms:Bone-RADS 1,leave alone;Bone-RADS 2,perform different imaging modality;Bone-RADS 3,perform follow-up imaging;Bone-RADS 4,biopsy and/or oncologic referral.This interpretation of guidelines intends to understand the Bone-RADS in detail,which will help radiologists better understand the diagnosis and management of isolated bone lesions encountered by chance in adult CT and MRI.
作者
戚荣丰
王敏
张龙江
QI Rongfeng;WANG Min;ZHANG Longjiang(Department of Medical Imaging,Affiliated Hospital of Medical School,Nanjing University/General Hospital of Eastern Theater Command,PLA,Nanjing 210002,Jiangsu,China)
出处
《医学研究与战创伤救治》
CAS
北大核心
2023年第2期113-119,共7页
Journal of Medical Research & Combat Trauma Care
基金
国家自然科学基金(81671672)
江苏省自然科学基金(BK20221554)。
关键词
偶发孤立性骨病变
CT
MRI
诊断管理
occasional isolated bone lesions
MRI
CT
diagnostic management
